New research released today (Tuesday 27th January) by RNID has exposed an overwhelming lack of NHS staff training in England on their legal duties towards people who are deaf or have hearing loss, leaving millions of adults facing significant health risks.
A series of Freedom of Information (FOI) requests from RNID – the national charity supporting the 18 million people who are deaf, have hearing loss or tinnitus – have revealed a shocking 92% of NHS staff in England have not completed training on the Accessible Information Standard (AIS).
The standard – which has been in place since 2016 – sets out patients’ rights under the Equality Act and ensures the NHS meets its obligations towards the needs of people with a disability or sensory loss.
The findings follow a damning report from charities RNID and SignHealth, Still Ignored: The Fight for Accessible Healthcare, which revealed how the NHS is routinely failing to apply the Accessible Information Standard, leaving over 6 million adults who are deaf or have hearing loss regularly facing an uphill struggle to get vital information on their own health – including serious illness.
RNID has been told of devastating cases including patients having not understood they are dying, that they have received a cancer diagnosis, or that they have experienced a miscarriage
The charity is calling for urgent action from the Government to address the issue and for the Accessible Information Standard training module to be made mandatory across the NHS.
In total, 212 hospital Trusts and ambulance services in England were asked by RNID how many of their staff had completed Accessible Information Standard training module. Of the Trusts that responded to the RNID with a figure, the majority (60%) reported that under 1% of their workforce had completed the training.
In addition, 10 hospital trusts in England reported that 0 members of staff have completed the training. These are:
Berkshire Healthcare NHS Foundation Trust
Chesterfield Royal Hospital NHS Foundation Trust
Derbyshire Community Health Services NHS Foundation Trust
London Ambulance Service NHS Trust
Sherwood Forest Hospitals NHS Foundation Trust
South Central Ambulance Service NHS Foundation Trust
Tameside and Glossop Integrated Care NHS Foundation Trust
The Walton Centre NHS Foundation Trust
University College London Hospitals NHS Foundation Trust
University Hospitals Dorset NHS Foundation Trust
Of the Trusts that responded, just 11 reported having workforces where 50% or more staff have completed the training module.
The Accessible Information Standard is in place to ensure that NHS and adult social care services offer extra support to meet the accessibility needs of people with sensory loss – support they are required to offer by law.
For example, providing people who are deaf or have hearing loss with an accessible alternative to the telephone to be able to book appointments or receive test results, or communication support, such as a qualified British Sign Language (BSL) interpreter to ensure they can understand appointments and procedures.
However, according to RNID and SignHealth’s Still Ignored report, as a result of the NHS failing to provide accessible healthcare: almost 1 in 10 people who are deaf or have hearing loss have avoided calling an ambulance or attending A&E, 1 in 4 have avoided seeking help for a new health concern and 7 out of 10 (70%) say they have never been asked about their communication needs.
An anonymous female sign-language user, aged 35-44 shares an account of visiting hospital in an emergency. She said: “I went into A&E for blood loss but no interpreters turned up after asking several times. I went through so many tests and wasn’t sure what it was all about. I was given medication, but I refused because I didn’t know why I needed them. The staff seemed gobsmacked, so I took it and was not sure how serious it was. The next thing a nurse took me into a bereavement room and sat me down with a leaflet that said ‘miscarriages’. I was in shock. They had not explained what the test was for. It was a massive misunderstanding and lack of communication.”
Pip Lee, a hearing aid user and lipreader, based in Suffolk, said: “It came to my appointment time and my pager hadn’t buzzed, so I sat tight. I vaguely heard someone shouting, and when I looked up everyone was looking at me. I waved at the shouting nurse, and it turned out she had been calling out my name. I explained that my pager hadn’t buzzed, and she apologised, repeating what the receptionist had told me; that nobody knew how to use the pagers, even though they’re really simple.
“But the situation got worse when I went in to see the consultant. He refused to take off his facemask, so I couldn’t hear anything he was saying. He picked up his iPad to use the speech-to-text function, but the text it produced was gobbledygook. I left only knowing that I would need an MRI of my brain, but when the post-appointment letter came, I was shocked to read it was to look for a possible tumour associated with my hearing loss and tinnitus. Because the medical staff did not meet my communication needs, I missed that important information. Thankfully I didn’t have a tumour, but the experience was up there as one of the most stressful, frustrating and patronising appointments I’d ever had.”
According to RNID research, NHS staff blame lack of training and time, plus poor IT systems and processes as major factors behind failings.
Worryingly, only one third (32%) of NHS staff say they are aware of the Accessible Information Standard and only a quarter (24%) say they can always meet the information and communication needs of patients who are deaf or have hearing loss.
NHS staff who do not feel confident that they can always meet patient needs face four main barriers: a lack of training (34%), a lack of time or capacity in workload (32%), a lack of standardised processes (31%) and a lack of functionality of IT systems (30%).
An update to the Accessible Information Standard was published in July 2025, but RNID has previously said the update does too little to ensure the NHS will follow it.
Dr Natasha Wilcock is a deaf doctor who works in palliative care. She said: “As a doctor, it’s clear that staff want to be able to communicate with deaf patients, but they have not had the right training to allow them to do so. This directly leads to deaf people experiencing poorer healthcare. Communicating effectively with deaf patients is not a fun, fluffy extra, but actually this can save lives, prolong lives and give patients better quality of life.”
Crystal Rolfe, Director of Health at RNID, said: “These responses from NHS Trusts up and down the country paint a bleak picture of the kind of communication you can expect if you need medical attention, and are deaf or have hearing loss.
“It’s very concerning but sadly not surprising that 92 percent of NHS staff have yet to complete such important training, potentially leaving millions at the mercy of substandard care, or worse.
“Deaf people and those with hearing loss shouldn’t have to think twice before calling an ambulance, or wonder if they’ve properly understood a diagnosis they’ve been given.
“Every day, healthcare in this country is letting people down because of an unequal and inaccessible service and this simply must change.
“We call on the Government to take this issue seriously and make AIS training mandatory, and ensure the NHS is a service that meets the needs of everyone.”
RNID is calling for training on the Accessible Information Standard to be made mandatory for all NHS staff. Other key recommendations from the charity, to meet the needs of people who are deaf or have hearing loss, include:
DHSC (Department of Health and Social Care) to ensure that work to improve the NHS Accessible Information Standard (AIS) is properly resourced and prioritised, and lead on a transformation plan to ensure that people with communication needs can access the healthcare they need.
The AIS to be enforceable for the NHS, through the strengthening of legislation on NHS information standards.
