Making the NHS App More Accessible for Everyone

The NHS App is more than technology. It is becoming the digital front door to healthcare, supporting the NHS Long Term Plan and the shift from analogue to digital. A true digital front door must be open to everyone, which means overcoming barriers to digital inclusion so people of all abilities can access the care they need. 

Accessibility is not just a legal requirement. It is central to creating a healthcare service that empowers people to manage their health and reflects the NHS mission of equal care for all. Guided by the Web Content Accessibility Guidelines (WCAG), we work to ensure the NHS App is perceivable, operable, understandable and robust. [Check four key areas by clicking this link to WCAG guidelines]

What we did

We worked in partnership with several thirds sector organisations and charities including NRAS, RNIB, Mencap and Slate. We held face to face sessions at RNIB's accessibility lab in their London offices, attending session informal group in both Sheffield and Leeds with individual with learning disabilities, conducted in-home interviews with those with physical disabilities and recruited people, who identified as neurodiverse, from the NHS App Panel to remoted online sessions. 

We developed a number of prototypes, in both native and html, compatible with both IOS and android devises and tested several journeys with the NHS App. 

What we learned

RNIB

For people with severe sight impairments, using the app was often a slow, step-by-step process. Screen reader users “swiped” through every single piece of content, memorising the order as they went. When content wasn’t grouped logically, this became confusing.

One participant told us:

“I got confused with the difference between the message... I thought the message came first and then who sent it came afterwards. Whereas the heading of who sent it was first...”

Magnification and zoom also didn’t always work reliably. Blind participants struggled to register during onboarding without support. These findings reminded us as researchers that prototypes need to be tested with accessibility settings switched on — otherwise, we risk missing fundamental barriers.

NRAS

For people with reduced dexterity, something as simple as tapping a small button could be exhausting. Chronic pain, fatigue, and reduced grip strength made swiping and scrolling particularly uncomfortable. Typing on a phone was often out of reach without alternatives like voice input.As one participant explained:

“If I could Scroll down a margin at the side, I'd be able to rest my hand on the table and scroll down more easily.”

This taught us that accessibility is also about physical comfort and safety. We need to design for one-handed use, provide multiple input methods, and ensure that people don’t feel they’ll drop their phone just by trying to book an appointment.

Neurodiverse users

Neurodiverse participants — including those with ADHD, autism, and dyslexia — told us that too much text quickly becomes overwhelming. Repeated content fades into the background, while changes to layout or flow can cause disorientation unless carefully signposted.

Visual aids made a real difference. As one user said:

“I like graphics and images and infographics — I’m more keen to capture with those icons rather than actually reading the text.”

These sessions reminded us that accessibility is about content design as much as interaction design. Clear structure, chunked information, and visual cues aren’t just “nice extras” — they’re vital for many people to engage confidently.

People with learning disabilities

For some participants with learning disabilities or low digital literacy, digital healthcare felt daunting. Some relied on carers or family members to use the app. Others preferred not to use digital services at all — often because of lack of access, mistrust, or fear of scams.

One participant told us plainly:

“I don’t bother – my mum would keep prompting me… I wouldn’t be comfortable doing it online.”

These conversations reminded us that inclusivity isn’t just about making features work — it’s also about building trust and confidence. Sometimes, accessibility means designing with carers in mind as much as with patients.

What We Learned as Researchers

Across all these groups, a common theme emerged: small design details can have a huge impact. Whether it’s adding a verbal cue to signal the end of a page, providing a scrollbar for easier navigation, or breaking up text into manageable chunks — these changes aren’t complex, but they are transformative. 

As researchers, it reminded us that accessibility is not a box-ticking exercise. It’s a commitment to listen, adapt, and continually improve. And it’s about making sure the NHS App works not just for the many, but for everyone. [Join ‘Beyond the Tick-Box - Confronting the Challenges of Adopting Meaningful Patient and Public Involvement’ at HETT Show 2025]

How the NHS UCD team supports accessibility

Accessibility isn’t an afterthought — it’s built into how we work. 

Through our User-Centred Design Centre of Expertise, we provide usability and accessibility labs, run audits to spot barriers early, and deliver ethics and safeguarding training so research is always inclusive and responsible. We also work closely with charities and third-sector partners to help user researchers recruit participants with diverse access needs. 

In the NHS App team, we make sure that every round of user research includes participants with access needs. We also run regular internal learning sessions to share practical tips on improving accessibility. 

And across NHS England, the Digital Accessibility Community meets fortnightly to discuss the latest accessibility issues, share insights, and learn from one another. It’s a vibrant space for collaboration that keeps inclusivity front and centre as we design digital health services. 

Closing

Join NHS England’s Accessibility Lab Live: From Analogue to Digital with Empathy and Innovation at HETT Show 2025. This interactive session will bring together NHS professionals, accessibility experts, and people with lived experience of disability and neurodiversity. Through hands-on demonstrations and personal stories, we’ll explore what it really takes to build inclusive digital services. 

If you want to experience accessibility first-hand and be inspired to design with empathy, this is a must-attend session!