"I carried out the instruction and the baby started kicking immediately" Award-winning text service supports African mums-to-be

“I was six months pregnant and my baby was not kicking. I was worried and planning to go to the health facility when I received the message that ‘if you are not sure the baby is kicking, sit-up, and take a cold drink.’ As soon as I carried out the instruction, the baby started kicking immediately,” says Itumo Nkechi in South Africa.

Praekelt's MomConnect system uses texts to reacj over 1 million South African mums

The Comic Relief Tech4Good for Africa Award 2017 has been won by MomConnect - an online and text messaging service for pregnant women and new mothers to receive vital medical advice.

More than 1.3 million South African mothers are currently registered on the platform, which was set up as a free service by the National Department of Health (NDOH) in South Africa. The NDOH works with an organisation called Praekelt. which designs and develops mobile technologies to deliver essential information and vital services to more than 100 million people in over 60 countries. The service gives pregnant women the chance to receive stage-based messaging from conception to the end of the first year of her baby’s life.

We caught up with the Praekelt team after the awards to find out more about their work. 

1 What did the AbilityNet Tech4Good Award mean to you?

So often with tech awards, we see them in the Silicon Valley or private space. Not only do we support these awards because they focus on Tech4Good, but we are proud to have won in the inaugural Africa category. African start-ups and technology are making headlines but still hardly get the attention they deserve.

2 What are the main ways you are using different tech platforms?

Our recent annual report focuses on our maternal health platforms and girl-focused mobile innovation projects. 

In Nigeria, the Hellomama programme addresses the fact that most women are illiterate and that SMS is seen as a premium service by utilising voice based technology for delivery of stage based messages. this pilot launched in two states of Nigeria in november 2016 and has registered over 6,000 women and gatekeepers and sent over 40,000 voice messages.

We also have our portfolio of programmes funded by Nike Foundation and supported by Girl Effect include Amadar Golpo, which uses interactive voice response (IVR) to offer peer leaders in BRAC’s Adolescent Development Programme additional support, training, and guidance; the financial literacy app Dooit in Indonesia; and the mobile mentorship programme, mentor To Go, in India.

3 What have you learned about what does and doesn't work?

What works is partnerships. Investing and spending time building partnerships with both global NGOs and governments is key to national-scale implementation. One of the reasons we are able to scale maternal health programmes in several African countries, is because of our partnership with governments.  We also very much believe in thinking of the users throughout the design and build process. 

We always build and create projects that are meant to scale from the start, to avoid problems with sustainability. We believe the power of mobile technology rests in scaling, and can often be complemented by local outreach.

4 Is there any tech/ new platforms that you're excited about?

The last decade has witnessed the incredible power of mobile phones and data connectivity when used to advance the delivery of vital information and services.  With the advance of data capable phones and the penetration of affordable IP connectivity, messaging solutions can now engage people at a previously unimaginable scale. These engagements will be richer, more conversational, immediate, and personal than ever before.
We look forward to how IP messaging, particularly Whatsapp, will make messaging more efficient and accessible for low and middle income communities.

5 What's next? 

At the moment, The NDOH and Praekelt are exploring how to reach mothers through different channels, such as WhatsApp. We have also been awarded a two-year grant from the Bill and Melinda Gates Foundation to explore how mobile technologies can improve communication with patients.

6 Is there anything else you’d like to say?

Inclusivity, of genders, ethnicities, and abilities, is a key focus for us, especially because of the people who are our end users. We really support women in technology, and are proud that our organisation is run by a woman, and that many of our senior team who helped implement and build our maternal health platforms are women.

More information

5 ways to get more out of your device, from longer battery life to better productivity

Last week, I talked about Stevie Wonder reading out the name of award winner Ed Sheeran at the Grammy's using a card with Braille on. It meant that Wonder could freely wave the card around safe in the knowledge that no one could read the answer over his shoulder. This idea that adjustments can often come with additional spin-off benefits that many wouldn’t immediately appreciate is a linked theme I’ve also touched upon time and again in my posts.

Check out my five quick tech tips with benefits here and impress your friends: 

1 Turn your screen black and use speech output for much longer battery life

The fact that I use speech output on all my devices means that I can turn on the 'screen curtain'  - a feature for blind users that turns the screen black on my Mac, iPhone and Apple Watch. This is a feature which, like Braille, not only helps me avoid anyone looking over my shoulder when I’m putting in pins, passwords or typing a sensitive email on my phone, but also has the simultaneous spin-off advantage that it considerably increases my battery life.

Don’t fancy using your phone eyes-free? I don’t blame you, but there are always cases where an adjustment makes sense. Next time you need to read a long document on your iPhone, for example, why not try running VoiceOver - you can assign it to the accessibility shortcut (triple-clicking the Home button) in the Accessibility settings - and then, with the screen blank and saving you battery, simply swipe down the screen with two fingers to start reading through the document from top to bottom. Nice.


2 Keyboard shortcuts for comfort and a productivity boost

If you use keyboard shortcuts for all your common computer tasks this means that you not only avoid discomfort from over-use of your mouse, but also enjoy an enormous productivity boost. This is because shortcuts often replace several mouse movements and clicks with a single quick keypress.

Whether you choose to use shortcuts because of a disability (I can’t see the arrow on the screen) or preference makes no difference. The adjustment, and its benefits, are there for everyone. Click here for Mac keyboard shortcuts: https://support.apple.com/en-us/HT201236 Click here for Microsoft keyboard shortcuts https://support.microsoft.com/en-gb/help/12445/windows-keyboard-shortcuts  

3 Dictate and use autocorrect or Grammarly for speed and perfect spelling

Similarly, if you choose to use voice recognition to dictate your texts, emails or longform documents because of disability or discomfort, you get the spin-off benefits of incredible productivity plus perfect spelling. Nice. See how to dictate text on MacOS 10.12 Sierra.

Adding your top 50 or 100 most commonly mis-spelt or mis-typed words into Office’s Autocorrect (or something like Grammarly) will avoid corrections but also make your documents easier to read when you’re still mid-draft. Those green and red squiggles can be really distracting and break your flow.

4 Change the colour of your device's screen - give your eyes a break

Whether or not you have dyslexia, I’d strongly recommend trying different background colours as they can be much easier on the eyes and improve legibility of text.  Read how to change background colours on a Mac and how to change background colours in Windows

5 Read the tiny font in apps more quicky by setting up a 'bigger text' shortcut

I could go on and on. Adjustments (including the accessibility settings built into every common desktop OS and smartphone) are there for all of us to explore. Some will be very niche; I suspect you’ll find it challenging to double your battery life by using speech alone (but I’d applaud you for giving it a go), while other adjustments - such as bumping the text size on your smartphone and assigning it to the accessibility shortcut on your phone, so you can easily activate it when reading the tiny font on some apps, will be something that the vast majority of users would love.

Can we get tech to work better for you? Give us a call on 0800 269 545.


Are floodgates open for US citizens to sue companies over inaccessible websites?

There’s been some great news from the US for fans of web accessibility; a spate of cases brought by blind people against companies who are breaching discrimination law by failing to make their websites accessible, have been upheld by judges in America.

There are very good legal reasons to think about accessibilityWebsites in the US and UK are legally obliged to be accessible to disabled people (under the Americans with Disabilities Act or the UK Equality Act), but few websites are truly inclusive to those who have disabilities such as sight or hearing loss. 

A new era for web accessibility cases

In the eyes of the law, disabled people are being discriminated against, but up until now it appears that few cases have been brought or upheld against websites and business owners around the accessibility of their sites. However, according to the US disability rights lawyer, Lainey Feingold, it looks like times are changing.

In recent months, judges in four different cases have upheld complaints against companies regarding the accessibility of their websites.

June saw what Feingold believes to be the first trial of its kind under the Americans with Disabilities Act (ADA). In Florida, a blind customer of the Winn-Dixon grocery chain, brought a court order against the company because he could not read the store’s online coupons using his screen reader or use other features on the site.

 After a two-day trial, the court ruled in the customer’s favour, however, Winn-Dixie has decided to appeal. It comes a decade after the high profile case which saw US chain Target ordered to pay more than $6 million in damage for failing to make their website accessible.

In the same month, a California judge upheld a case brought by a blind customer of arts and craft brand Hobby Lobby. And in July, a judge in a New York federal court ruled that a web accessibility case against Five Guys restaurant chain should continue.

Biggest support yet for web accessibility?

This month, in what is perhaps the strongest support for web accessibility in the past several years according to Feingold, a federal judge in New York issued a “blistering and passionate defense of web accessibility” in refusing to throw out a web accessibility case against Blick Art Materials.

The Target case took three years and so we might not see the results of these cases for quite a while, but the fact that more companies are being challenged is a positive step for anti-discrimination.

Look out for more on this in up-coming blogs by AbilityNet's head of digital inclusion, Robin Chistopherson.

You might also be interested in:

Stevie Wonder says: Everything needs to be accessible to everyone

I've just come across the fantastic clip of the great Stevie Wonder, world-famous blind singer and tech advocate, speaking out on the importance of inclusive design at the glittering Grammy Awards.

Stevie – A wonderful advocate for accessibility

Last week I spotted a tweet that took me to a short but very inspiring clip on Youtube. It was of Stevie Wonder - a really nice chap and fellow technology advocate (he’s a pretty fine singer too!) and someone I've been very fortunate to meet in person. The clip was of him at the 58th Grammy Awards in 2015 and he had an important message for us all. 

Before announcing Ed Sheeran as winner of Song of the Year (for Thinking Out Loud), Wonder made a plea to the listening millions: “We need to make every single thing accessible to every single person with a disability.” This elicited a huge supportive response from the audience.

This passionate plea reminded me very strongly of our clarion call here at AbilityNet – a call for people to consider accessibility as nothing less than designing for everyone.

In many of my recent posts we explore how, in a world where mobile is often the go-to tech for most users, accessibility not only helps disabled people take part in this rich digital revolution, but how it’s actually also essential for everyone.


READ NOW Revolutionising tech for blind people: Is this the world's first multi-line braille reader?


We all use these small but oh-so-handy devices in all the extreme environments we find ourselves in every day - from juggling a phone one-handed, to squinting at your screen in the glare of the sun – check out many of my posts to explore this discussion in depth - believe me when I say that accessibility is no longer the domain of people with disabilities. Let’s call it ‘inclusive design’ and put it at the heart of every design, development and marketing decision we make.

It’s a wonderful world where small adjustments make a big difference

The other aspect of his appearance, that also happens to be a hot topic I’ve touched upon in many of my recent posts, was Wonder's use of a reasonable adjustment that itself also comes with unique benefits.

A reasonable adjustment (in the US it’s called an ‘accommodation’) is a tweak to how things are normally done (and often costs little or nothing to put in place) and it’s aim is to assist someone to meet a need associated with their disability or impairment.

Being blind, Stevie’s adjustment was to have a Braille version of the winning announcement. As a result of this simple adjustment he was able to read the winner himself – but not only that, he could be confident that no one would be able to get an advance sneak-peak at the name of the lucky winner - Ed Sheeran - over his shoulder.

Of course, such privacy might not have been that important here, but in our daily lives as blind people out and about, we often need to read sensitive information and often have no idea who is around us. Braille helps us be confident in the knowledge that anyone watching can’t read it. It’s an adjustment. But more than that, like so many adjustments, it comes with added benefits. More about that in an upcoming blog. 

It was Stevie Wonder's playful comment about his unusual Braille version of the famous winner’s envelope that prompted him to proceed to the much bigger plea for inclusive design we see above.

Wondering what adjustments Stevie uses?

Stevie Wonder is a huge advocate and user of tech. We once compared our gadgets and adjustments and believe me when I say that he, like me, finds the ever-changing advancements in tech a real eye-opener (I’m allowed to use cheesy puns like that).

Long-established adjustments such as Braille, and cutting edge tech such as voice-enabled smartphones, both have their role to play. I wonder if Stevie has an Amazon Echo? Voice-in, voice-out used to be a very specialised adjustment that was the very niche domain of people with both a significant motor and vision impairment. Talk about an adjustment with spin-off benefits!

So let’s end with a gratuitous plug for my daily Dot to Dot podcast covering top tips and skills to ensure that everyone gets the most out of their Echo. My blogs about Alexa and the Echo are always the most popular, too. 


How some simple tech adjustments can help you work with arthritis

Monday morning, in my slightly dozy state I was half listening to the radio. The BBC was running a piece on arthritis linking in to a new campaign published by Arthritis Research UK  - The Nation's Joint Problem.

Several things occured to me while listening to the piece. The main thing was that they were interviewing people in their 20s and 30s.  Most of the clients that we talk to about arthritis tend to be much older. Some of them have retired or don't have too much of their working lives left.

screenshot of arthritis research UK The Nation's Joint Problem report

If you're in your twenties and have arthritis, can you still work?

The campaign focuses on the charity's new report titled the State of Musculoskeletal Health, which examines all the working days that might be lost by people who have arthritis. We like to focus on how people can continue working with different conditions, should they wish to. Through having a bit of knowledge about what technology and computers can do to support someone, simple adjustments can often make a really big difference. We can even send a free volunteer to help you get to grips with new ways of working with tech

Can you get help to work with arthritis?

If you're a student with a disability or chronic condition or someone in work with a disability or chronic condition and you need help to continue working, we'll offer you plenty of advice and support. 

The campaign highlights that there are over 10 million people living with arthritis and the fact that the condition can cause high levels of daily pain and fatigue.

Nigel Lewis, CEO of AbilityNet, commented: "The National Joint Problem report launched this week by Arthritis Research UK highlights how critical workplace reasonable adjustment is to help reduce some of the 25.1 million days lost to the UK economy (through arthritis). Arthritis is just one condition that can be helped when employers make reasonable adjustments to support their staff to get into and stay in work, which not only benefits the economy, but more importantly helps the individuals throughout their lives."







World's first multi-line braille e-reader for blind people wins coveted AbilityNet Tech4Good Accessibility Award

Canute multi line braille e-reader

Reading an adventure story with your child is perhaps one of the foremost pleasures of parenting. Dave Williams loves it when his eight year old son turns a page in his latest Harry Potter and asks him to do the Hagrid voice.

Without sight since his own childhood, Williams waits patiently for the relevant line to load on his single line braille reader before he can continue the story. The timing of the adventure can be lost and it can be frustrating to not be able to read a whole page at a time. 

The dad is the sort of person for whom inventor Ed Rogers has created the world's first refreshable multi-line braille e-reader, the Canute.

the Canute slim wooden box

The device means a person using braille doesn't have to wait for each line of a story or page to load one-by-one, and so offers mums and dads with sight loss a modern method for reading the bedtime tale; cooks a great way to read a recipe, and mathematicians an easier method for grasping a formula; some things just make more sense when presented on multiple lines, rather than on a single line.

Last month Rogers picked up the coveted Accessibility prize at the AbilityNet Tech4Good awards, supported by BT, for his invention. His wooden box e-reader is beautifully old fashioned with more than a thousand cogs and connectors. The invention which measures 14inch by 8inch by 2inch and weighs just under 3KG, works by a user uploading text via a USB or SD card from a phone or computer, which the machine then turns into the raised dots to make up the braille language. 

But, despite its old-skoolness, it still seems to be the only piece of kit around which produces a whole page of braille at a time - forty characters per line by nine lines; a sort of kindle for blind people. Plenty have attempted something similar but there appears to be nothing on the market as yet. He aims to price it at the £650 mark - around the same as a new iPhone or the single line Perkins braille reader.

Save the Braille

Williams is a member of a group called The Braillists who’ve worked with Rogers, founder of non-profit Bristol Braille Technology (BBT), to offer constructive feedback on the Canute for much of the six years BBT has been working on it.

The dad and assistive tech expert wasn't always a fan of braille though. “I lost interest in braille after school,” Williams admits. “I felt it made me stand out and feel separate from others. It’s only since I’ve started working and had a family I really see its value. It means I can do speeches and presentations easily at work and of course, I can read with my son.

Braille technology has been in stagnation since the 1970s, and few paper books, including school text books, make it to braille; braille literacy is in decline, which text-to-speech technology filling some of the gaps.

Advances in text-to-speech do have their uses, but they do not substitute the joy, skill and beauty of reading, Williams says. “Braille enables you to find own voice, a speech synthesiser is someone else’s interpretation. When you read yourself, you process in a very different way, you find the voices in the Harry Potter stories.”

Rogers' latest prototype, which he hopes to finally get on to the market by next spring, is the smallest and most adept yet; at about the size of a small computer. “It’s more accurate and quicker than previous versions (which haven't gone to market), according to Williams."

The Holy Braille?

The inventor knew no blind people when he started the project and himself is sighted. He was an animation student who simply found the technological challenge of producing a multi-line braille e-reader both fascinating and socially essential. “This is a labour of love. Braille literacy is very important, I don’t want it to be lost,” he says.

On winning the award, he adds: "It came just after an extraordinarily long stretch of work to finish the Canute Mk13 prototype (latest version) in time for a convention in the States. We certainly weren't expecting to win but we're very grateful for the recognition after so many
years' work."


Alzheimer's Society issues guidance on creating dementia-friendly websites

Did you know that as vision declines with age, the colour blue is the most difficult to make out? Avoid use of blue on websites for older people, particularly on important interface elements - this is one of the tips given in the Alzheimer's Society's latest guidance on making websites user-friendly for people living with dementia.

two older people using a computer together

There are currently one million people living with dementia in the UK and this is expected to increase to two million by 2050. People with dementia can experience difficulties in the following areas:

  • Confusion
  • Perception and vision
  • Problem solving and thinking speed
  • Judgment
  • Processing and sequencing information
  • Language and words

When a developer, company or designer keeps all potential users in mind, the experience and results are better for everyone: more inclusivity and increased website users.

As big fans of accessible and user-friendly websites, it's great to see Alzheimer's Society offering detailed advice on creating a dementia-friendly site. Earlier in the year, AbilityNet also ran a popular Dementia and Digital Design webinar to assist companies, designers and developers in their efforts in this area.

Here we've included some of Alzheimer's Society's top tips on creating a dementia-friendly website:

1 Work with those living with alzheimer's at all stages of design

You could find people through dementia forums, like Talking Point  or by approaching local services in your area like Dementia Cafes, as well as by using social media or specialist research participant recruiters.

2 Be very clear

Make it completely obvious on every page what your site is and what it is for.

3 Use relevant images

Keep images simple, engaging and meaningful. Make sure they're closely related to content. Images are good for contextual understanding for this audience.

4 Avoid ambiguous words and sentences

Avoid complex jargon or calls to action with no context. Use literal descriptions, clear headlines and don't be ambiguous.

5 Avoid the colour blue

Vision declines with age and most people with dementia are in the older age bracket. Blue can be particularly difficult to see, so avoid this colour, especially for important interface elements.

School's out for summer...but here's how disabled students starting uni in autumn can get the right support

It seems like the summer holidays have just started, but it won't be too long before new students are going off to university for the first time. In 2016, Disability Rights UK came up with some handy guidance for disabled students about what Adjustments could be made by universities to help those students with a disability. It isn’t exhaustive, but it very long and does give some really useful hints and tips on what to do in order to accommodate students who might have additional needs and provide a more inclusive service.

The guidance is split into different categories.  So for example, under the General heading the guidance talks about university staff having disability awareness training so they are better informed to support students who might have additional needs.  Another category relates to General Access requirements. So for example you might require a longer time to complete an exam paper, and you may also need some rest breaks being built in so you can manage symptoms of fatigue more effectively. 

The last category relates to disability specific needs. So, for example, if a student has vision loss, they may need specific support in making hand-outs easier to read. So they might need to recieve hand outs on different coloured paper, or in larger print.

Those with hearing loss might need some of the following:

  • 'Remote captioning eg, using Skype to access a palantypist
  • Changing the language of exam papers if you’re pre-lingually deaf
  • Induction loop system in lecture halls and seminar rooms
  • Radio or infrared microphone system
  • Textphone (e.g. minicom) at home, in the Students’ Union and/or somewhere easily accessible at the college

It's hard to know how many higher education students claimed Disabled Student Allowance (DSA) across the board last year. AbilityNet carried out assessments for approximately 1800 students last year with a view to them receiving DSA. Some of the students we assessed had conditions such as dyslexia, or dyspraxia, others had depression and anxiety issues, as well as hearing and sight loss and it the difference that can be made with some simple help, is extraordionary.

In 2016 the Association of Colleges reported that between 2015-2016 some 2.9 million people were educated or trained at college.  Many of those students will have some sort of impairment that needs support.

It is one thing to explain on an enrolment form that you have a disability but another entirely for the education institution to put measures in place to help you. Under the Equality Act 2010, they must make reasonable adjustments to support you. 

Disabled students don’t want to shout about their disability, so it does make sense for staff to be well briefed on the additional requirements they might have. They also wants to be seen as individuals, so just because a member of staf helped a student with dyslexia last year and they have another student who has dyslexia this year, both might have had different requirements.

If you have students, or are a student who struggles with their IT and need some advice on adaptive equipment, you can always Ask Alex (me) AbilityNet's Advice and Information officer. I used IT equipment all throughout college and university to produce work of a high standard and I as don’t have all my fingers it makes writing really difficult.

How can we help?

AbilityNet provides a range of services to help disabled people and older people.

Call our free Helpline. Our friendly, knowledgeable staff will discuss any kind of computer problem and do their best to come up with a solution. We’re open Monday to Friday from 9am to 5pm on 0800 269 545.

If you are in work your employers have a responsibility to make Reasonable Adjustment.   For more details on this have a look at www.abilitynet.org.uk/ctod and www.cleartalentsatwork.com

Arrange a home visit. We have a network of AbilityNet ITCanHelp volunteers who can help if you have technical issues with your computer systems. They can come to your home, or help you over the phone.


Microsoft is bridging the communication gap with advanced voice recognition and translation services

Microsoft is combining quick, reliable voice recognition with instant language translation and embedding it into more and more of its products - bridging the communication gap across countries and eroding the barriers of disability.

In the future of computing, your voice will be heard

Talking to your computer, smartphone or ever-helpful home assistants such as Microsoft/ Harman Kardon's up-coming Invoke speaker with Cortana (pictured below), the Amazon Echo or Google Home is now so normal that it’s become second nature for many of us. Of course they’re still far from perfect, but anyone who has experienced the uncanny ability of these assistants to correctly answer shouted questions from across a busy room is left with a feeling of wonder and a strong desire to ask another dozen or so questions to experience the magic some more.

Cortana and Harman Kardon Invoke speaker

For people with disabilities the magic is taken to a whole new level and there is little doubt that natural language smart assistants are going to play a major part in the future of computing.

The ability for these devices to help us with our requests is partly due to the AI smarts behind the scenes, but a large part is the increasingly accurate ability for them to understand exactly what we’re saying regardless of our accent, environment and language.


HAVE YOU READ? 5 ways the NHS disables blind people, and 5 ways it could help 


There’s some way to go with regards extreme levels of background noice (although machine learning is doing it’s best to learn how to filter out extraneous sounds) and recognising people with a speech impairment or disability, but the collosal number of people now using these devices is feeding vast amounts of valuable data into the central AI systems that drive these devices. Without buying a new gadget, or even having to update their software, these assistants will become better and better and more and more useful.

Microsoft - bringing language smarts to many platforms

While almost every operating system and device now has dictation capabilities built-in, Microsoft seems to be in the vanguard when it comes to embedding voice recognition and translation services across their most popular platforms and apps.

Speech recognition has been built into Windows for many years now and is getting better all the time. You can dictate into any application at up to 300 words a minute – faster than any touch-typist and with 100% accurate spelling too.

A more recent development is the ability to have live subtitles viewable by audience members while you present using PowerPoint. Check out this excellent article on their new Presentation Translator capability that not only provides live subtitles, but can also instantly translate them into several dozen languages. Individual attendees can even view synchronised subtitles in their own preferred language on their phone.

skype translator

Similar smarts have been available in Skype for some time. Skype Translator allows you to have voice conversations instantly translated into other languages and spoken out using clear synthetic speech – bridging the communication gap between millions of people world-wide. Not only that, but it’s available built-in to all recent versions of Skype on computers running Windows 7 and above.

Synchronised speech and text - assisting communication across impairments

Now consider someone with a hearing impairment. With Skype Translator the recognised text is not only spoken out but also comes up on-screen. This means that they can now read the other half of the conversation real-time and are now able to participate in a typical Skype voice call. Not a multi-lingual conversation?

No problem – simply set the language to be translated into to be the same as your own - i.e. set the language of both speaker’s to ‘English’, for example.
If you also have a communication impairment (many people who are born hard of hearing do) then no problem, you type your responses and the other speaker talks as normal and you’ll get their recognised speech as text on-screen.

This seamless integration of text and speech is a truly powerful combination of technologies, bridging the gap in communication across countries and disabilities.

Kudos to Microsoft for providing such power in these hugely popular applications – and when you combine this with the excellent image and object recognition  services they’re developing (that similarly disproportionately assists those with a disability or impairment) and the all-round excellent accessibility across all their platforms – Microsoft are really on fire at the moment when it comes to inclusive design. Guys, keep up the good work.

Here’s to a future in which the voice of every user can be heard and understood.


5 ways the NHS disables blind people, and 5 ways it could help

*Jim lost most of his sight as a teenager because of a genetic eye condition. To support him, teachers would make his notes in class and his text books would be audio recorded for him. These days, he can read faster than sighted peers thanks to a screenreader, but he still finds himself disabled when dealing with the NHS.

doctors sit in front of high tech screens

Jim says: “I've had a few health issues over the last five years and it's felt like I've been thrown back into the dark ages. My independence stripped away; I've missed out on important information regarding my health and have had to rely on other people because lots of things are done on paper rather than electronically. This can be embarrassing and demoralising.”

Here he explains his experience and offers suggestions on how the NHS can be more supportive to patients with sight loss and other disabilities.  

5 ways the NHS experience isn't working for blind people

1 Medical records

For the last five years (until recently) I was – wrongly - told I had IBS. I asked my doctor about seeing my records but they said they couldn't email them to me, only print them out. I can't read a print out and it isn't always ideal to have someone else read your health information for you. This is not inclusive.

2 General written advice

Over the years, the doctor has given me slips of paper about tests and prescriptions, but I can't read them either. It's frustrating and you start to lose your independence. 

3 Prescriptions

When the chemist gives me information about when to take medication and side effects etc., I can't read that information, which can cause big problems and confusion.

It was only after four years of taking a medication for acid reflux that I realised that I shouldn't have be taking the medicine during a meal, it should be taken an hour before eating. I was also on another medication for IBS that relaxes the muscle above your tummy and I found out this results in more acid leaking up, so for someone with acid reflux, this not a great thing.

4 Appointment letters

After four years, I made the doctor refer me to hospital for a colonoscopy. They sent a letter telling me about the hospital appointment preparations, which I couldn't read. A neighbour tried to help, but it got embarrassing when the letter started talking about laxatives. I asked for the information electronically, but was told they couldn't do that and could only send a picture of the information electronically, which a screenreader can't decipher.

5 Test results

I had some tests at hospital and they found a small bacterial growth in my small intestine, so I didn't have IBS in the end. They gave me a letter with some information about the tests for my doctor. I couldn't read it. I asked for an electronic copy, but the member of staff insisted there was no need because it was for my GP rather than me anyway!

I mentioned the new Accessible Information Standard (a mandatory code of practice for the NHS as of last year) and declared that I wasn't happy because the letter could say anything; how did I know for sure it didn't say 'donate his kidneys to charity next week'? At that point she took me more seriously. But it took a whole lot of energy. 


How the NHS can help blind and disabled people have a better experience

1 Spread more awareness of the Patient Access Online service, and make it more extensive

Jim had been going to his GP for years no one told him about the Patient Access site. The site offers some information to be read online, in some areas of the UK - the offering varies. Ensuring comprehensive information is provided on the site including details on medical history and past and present medication, together with side-affects and instructions on when and how to take prescribed medication, is essential for inclusivity. Ideally login details for the site should be provided in a way a blind patient can read. Jim found his doctor could only give him a print out/ letter with login details.

2 Exercise thoughtfulness and consideration

Jim found an amazing administrator who went out of her way to email him letters, but she got into trouble for doing so as it was against policy. Security issues around online information are sometimes stated as reasons for not providing more information electronically, but Jim has been told recently that there is a policy around how to securely email patients after all. 

3 Educate staff about disabled patients' requirements

Everyone who is in touch with patients, from the receptionist as the first port of call, through to surgeons, should know how to offer the best service for people of all abilities to feel empowered and independent.

4 Provide orientation and travel support

More help for disabled people travelling to hospital and a network of volunteers to help someone who is blind to get around the hospital would be most useful. 

5 More electronic information
“IT systems need to be in place to stop the NHS disabling me,” says Jim. “I hope for the day I can manage my healthcare - from knowing when my next appointment is and how to prepare for it, to ordering my repeat prescription and reading my medical history on my phone electronically’.

*Jim is an alias name given to protect anonymity