Sarah Thew, December 2020
Sumaira uses lived experience of overcoming accessibility barriers to influence positive change in health, education and public & patient involvement & engagement. Sumaira is an everyday activist, volunteer, trans disciplinary researcher and scholar. Sumaira holds creativity in high esteem.
Author, Blogger, Keynote Speaker, (TEDxNHS 2017), Usability and Accessibility Consultant, Sigma
Managing Director, Sigma, human centred design consultancy
One Health Tech Manchester, User Centred Design Specialist, Panel chair
Our panel began life as a series of conversations I had with Sumaira Naseem earlier this year, all about the impact the pandemic has made on health services, the rapid adoption of digital health tech, and the consequences for accessibility. Some of the things she’d noticed were big improvements, for example the move to on-line meetings and seminars, and the use of tele-consultations reducing the need for difficult journeys to face to face appointments. But she’d also noticed some problems, for example rapid reorganisations of services that weren’t explained to their users. We wondered how much thought had been given to accessibility in lots of the new digital health tools that have been rolled out very quickly this year.
That led OHT Manchester to plan this event, and we invited Hilary and Molly from Sigma to join us in sharing their experiences of digital health accessibility. Molly began by talking about her experiences with the NHS Covid tracker app, commenting on the difficulty of finding information and the alarming way in which some messages were worded (that subsequently turned out to be nothing to worry about). As Molly said, not nice for anyone but particularly difficult for anyone already coping with anxiety.
Sumaira went on to talk about how the way in which accessibility is discussed can feel very othering, as though it’s something done only on obligation and only for a small and ‘different’ group of users. This clearly isn’t the case, one in five of us has a long-term illness or disability and for many more of us, temporary changes to our situation such as pregnancy or a broken wrist can mean we need to take advantage of features designed for accessibility. Accessibility is not synonymous with disability and viewing accessibility as a bonus for a marginalised group of people isn’t ethical but also doesn’t make commercial sense.
We moved on to discuss the impact that recent legislation has made on organisations’ approaches to developing accessible technology, in particular the Public Sector Bodies (Websites and Mobile Applications) (No. 2) Accessibility Regulations 2018 . This requires public sector organisations to carry out accessibility testing, and to include an accessibility statement on their website which sets out any issues with the testing of their site, and their plans to address the gaps. The panel all agreed: this is a start, and it has got people thinking about accessibility, but it often tends to be seen as an obligation they must tick-off as complete, rather than as an opportunity to improve access and inclusivity, and to widen their pool of users.
So, we agreed that current approach tends to focus on the standards, rather than the needs, goals and behaviours of actual humans, and as Sumaira observed, it’s very reductive, and can feel quite othering.
How can design teams move to more meaningful, rounded engagement with people who have accessibility needs?
Hilary talked us through the co-design approach that her team at Sigma have adopted, involving a wider range of people with accessibility needs embedded in the design, testing and development of technology. It’s been a way to gain a richer understanding of the demands and benefits of building accessibility, as well as a useful and fun experience for all of the team members. Hilary gave us some key pieces of advice to start co-designing for accessibility:
1. Accessibility is vital in centring the needs of disabled people but inclusion takes more than standards compliance.
2. Research, design and test with people, not for them, which includes changing your processes, network and team.
3. Don’t put people in boxes, as disabilities can be complex, intersectional and lead to stress, pain and anxieties we need to design for.
4. Do the work to make things better, thinking beyond testing and audits to embedding lasting knowledge and skills in your teams.
5. Buy better, through insisting on accessible products and services in your procurement and commissioning
Sumaira and Molly described their positive experiences of being part of co-design projects, and Sumaira commented that ‘Just enabling people with disabilities to be in the room, allows people to have confidence to ask things and comment on changes.'
Covid has forced the rapid adoption of technology in healthcare, and we all agreed, there are lots of benefits. Longer term some of these changes will stick, and lots of it has understandably been done urgently, without the opportunity to think about accessibility, inclusivity, wider potential for transformation. We hope that in the next few years, it will be possible to reflect and revisit these changes and ensure they offer change and opportunity for all users. We need to caution against a digital only approach in healthcare, and treat technology and other digital components as integral elements of a human oriented healthcare system.
Thank you again to our excellent panellists for such an interesting and engaging discussion, and to everyone who joined us. We look forward to seeing you soon!