Stage 1 – Identifying needs

Asking service users, carers and parents to define their information and communication support needs is fundamental to AIS. Providers should record these needs so service users receive information in a way that aids two-way communication with staff.

Picture of Service user along side a quote

“I think the NHS could help people like myself and the staff to be more efficient by having systems in place so that people aren’t guessing what my requirements are.”


Chris Jenkins
service user

It is important for the staff member to ask and record how a service user wishes to receive communication. It is not helpful to record, for example, that a person is ‘deaf’, because being ‘deaf’ does not explain the ability to read written English, whether British Sign Language (BSL) and a BSL interpreter needs to be present, or a preference to have someone speaking to them at eye level (if lip-reading). They may prefer to receive information in writing (document, letter or through the internet). Staff should not make assumptions of needs.

Subsequent changes to communication needs must be recorded only with advice and consent from the service-user.

Asking a person about information or communication support needs should be done when the person visits the organisation’s premises or makes contact for the first time. If this contact is by telephone or email, the next opportunity to have this discussion should be in person (a visit to the organisation). The telephone or an online questionnaire can be used if a visit is difficult to arrange. When face-to-face conversations take place and the intention is to capture communication needs, a private room should be offered.


Tips for clear face-to-face communication

  • Make sure you get the service user’s attention - if they have not heard you, wave or tap them lightly on the shoulder.
  • Identify yourself clearly, explaining who you are, what you do and your reason for this conversation. Just saying your job title will not be helpful.
  • Check you are in the best position to communicate; facing the person. Communication is best done at eye level.
  • Find a suitable place to talk with good lighting and away from background noise or distractions.
  • Speak clearly and slower than usual. You do not need to shout.
  • Keep your face and lips visible. If a member of staff has concerns about removing clothing for religious reasons, they should discuss this with their manager.
  • Use gestures and facial expressions supporting verbal statements.
  • If necessary, repeat phrases, re-phrase the sentence or use simpler words.
  • Use plain, direct language, avoiding figures of speech such as ‘it’s raining cats and dogs’ or euphemisms like ‘expecting the patter of tiny feet’.
  • Check the person has understood what you are saying. Look for visual clues of understanding.
  • Encourage the service user to ask questions or request further information. Be prepared to provide key responses in writing.
  • Try different ways to get your point across, writing things down, drawing or using symbols or objects to support points.

Take the Test

Accessible Information
Standard Module

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Questions and prompts to identify needs

Ask questions when the service user first makes contact with the service provider organisation or at the next opportunity – by phone or using an online questionnaire.

Some individuals may willingly share information about their specific communications needs, while others may need support such as prompts, additional questions and/or gestures.

Initial questions must be generic and easy to understand so that the service user, their carers or parents can easily respond.

The organisation, service, team, department or ward needs to agree one or more questions that are standard to maintain consistency in communications.

Feedback from patients and patient groups advises us that terms like ‘disabled’ or ‘disability’ are best avoided to maximise response rates and reduce stigma. Staff in provider organisations must be encouraged to ask these questions to all patients – including those who do not perceive they have special communication needs.

Provider organisations should know that the Standard only provides guidance to manage the communication needs of people with sensory impairments or loss and those with learning disabilities.


The AIS guidance does not cover a service user’s inability to speak or read English.

Suggested questions to identify whether a service user has information and or communication support needs, and the nature of these needs include:

  • Do you need a format other than standard print (Arial, size 12 or above) to read a document?
  • Do you have any special communication needs?
  • How do you want us to communicate with you?
  • What communications support will help you?
  • What is the best way for us to send you information?

Read the full AIS guidance here