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Three-quarters of GP practice websites do not meet readability standards, study finds

by Jess Hacker
9 April 2021

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The websites of more than three-quarters of GP practices were more difficult to read than is recommended, a study has found.

Published in the British Journal of General Practice (BJGP), the study assessed the ‘readability’ of all of the 813 practices in Scotland with a website, assessed against NHS England’s Information Standard and the UK government website’s design system.

It found that 77% of the 3,823 web pages assessed featured information that exceeded the recommended 9 to 14-year-old reading age for online content.

The study found ‘no evidence that practice websites were adapted to meet the likely literacy levels of the populations they serve’.

Low basic literacy and low health literacy are associated with higher levels of socioeconomic deprivation, noted the study’s authors. Being able to access information easily is particularly important with the increased uptake of digital health during the Covid-10 pandemic.

The study, the most comprehensive assessment of GP websites’ readability to date, suggested that a lack of resources, such as funding, to improve practice websites could ‘inadvertently widen health inequalities’.

It said: ‘In a time of scarce resources, partnerships between patient participation groups, literacy charities/campaign bodies, government, and practices may be necessary to ensure digital changes are inclusive.’

In a review of adult literacy, 5.8 million people in England and Northern Ireland scored at the lowest level of proficiency in literacy with similar results in Scotland.

NHSE says that healthcare jargon adds complexity even for those who otherwise have good literacy levels, and that 43% of written health information is ‘too complex for UK adults to fully understand’.

The study also found that only 6.7% of the websites met ‘accessibility’ and ‘design’ recommendations.

Improving website readability

Several actions that practices can take to improve their websites were suggested in the paper, based on NHS England’s Information Standard and the UK government website’s design system.

These included:

  • Use of sans serif fonts (ones without curves and flicks) in headings and body text
  • A single, consistent font
  • Subheadings, bullet points and other features that make a page easy to scan through
  • Only using bold text for emphasis
  • No block capitals
  • No italics
  • Contrast between text and background colour
  • Making sure the website automatically adjusts when viewed on a smartphone.

Additional steps should be taken if a site has images, including captioning all pictures and making sure each image features alt text (a description of the image that screen-reading software can read aloud for people who are partially sighted).

Text should avoid jargon and use everyday language, be written in the first person, and should use an active voice instead of a passive one.

Other factors include character count, word count, and the number of sentences per paragraph.

Improvements are best assessed by testing websites with their target users, suggested the authors.