The Christie Charity
We have carried out a disproportionate burden assessment on our patient information and chemotherapy regimens documents.
Scope
As of September 2018, accessibility legislation states that public sector websites must publish content in an accessible format. These documents are published on our website as PDFs of varying sizes.
Benefits of creating an accessible version
The benefits of creating an HTML version of these documents would be:
- Fully accessible versions for all users to access
- Documents that are more easily searchable and indexable
Burden
- There are over 800 pieces of patient information documents created by the organisation
- Each document would require several hours of work to be recreated in a fully accessible version (estimated to take between 2 and 40 hours per document, depending on length and complexity, plus any additional sign off).
- In some cases, due to the way the leaflet/booklet has been created in the template as a print ready document, creating an accessible version could take weeks
- We have received a quote to outsource the creation of these documents into accessible versions and the trust does not have the budget to do this
- Many of these documents contain complex elements of cancer treatments using diagrams which would be difficult to retrospectively convert and would not be a good use of our clinical staff time. Our clinical teams are already stretched and therefore taking time out to convert documents and diagrams would not be feasible
Other factors
Also, relevant to the decision are that:
- To date we have not been asked for accessible versions of any of these documents but the need to have these documents on the website is explained below:
- Christie patients have access to a number of Christie services away from the Christie site Closer to their homes, one of the Trust strategies is to provide access to cancer services closer to our patients home. To be able to do that we need to provide an equitable service for all our patients which means access to the same information that can be provided when patients visit The Christie. This means that patients need to be able to access all the same information remotely.
- Patients must have access to reliable information to make informed decisions about their treatment.
- There would be a reputational risk to the Trust if we were not able to provide reliable information for all our patient, wherever they are treated.
- All our information leaflets are important, by providing only the most used leaflets discriminates against those patients with rarer cancers, where it is probably more important for them to have access to information about a rare disease.
- Delays in patient decision making means delays in starting treatment, which could affect patient outcomes.
Assessment
Having considered the estimated effort involved in creating HTML versions of all these documents, we have concluded that the work involved would be a poor use of limited staff time. This represents a disproportionate burden on the organisation.
Going forward newly approved patient information documents will be added to the website both as accessible web pages and PDFs. This will take place after each month’s patient information committee, and at the end of the three-year cycle of reviewing patient information documents they will all be included on the website as accessible web pages and PDFs.
We have over 30 of the most accessed documents as both accessible HTML versions and PDFs.
We will also continue to offer accessible versions on request.