Writing in plain language

When we write letters, emails, patient information leaflets, booklets or consent forms, we consider:

vocabulary and numbers

structuring our writing

designing our documents for print

techniques and resources for creating content

Vocabulary and numbers

Vocabulary

We use everyday language and:

• explain unfamiliar words or medical terms in our information. If this clutters our text, we put the explanations in a glossary at the end of our written information
• use consistent terms. Use one and stick to it. For example, we don’t use ‘assessment’, ‘check up’ and ‘appointment’ in the same document
• explain abbreviations at first mention. For example, occupational therapist (OT). We avoid overusing abbreviations
• avoid acronyms, slang or jargon, negative phrases, humour and Latin or French terms, for example, etc, e.g., i.e., au fait and et al
• do not quote regulations and laws unless we must, and we explain them very clearly when we use them
• avoid formal and complicated words, for example:

Numbers

We describe numbers consistently. For example, we don’t use percentages and fractions in the same text.

We explain the meaning of numbers. For example, we use terms like ‘low risk’ and ‘high risk’.

Words such as ‘majority’, ‘common’ and ‘frequent’ are not easy to interpret. We use numbers instead, for example:

Online dictionaries

Find our list of medical terms and how to explain them

These online dictionaries can also help to explain difficult terms. They contain plainer alternative words and explanations for medical terms.

• The Plain English Campaign in the United Kingdom has an A-Z of alternative easy words
• The Plain Language Commission in the United Kingdom has 3,000 words with plainer alternatives and a grading of how difficult each word is
• The Health Information and Quality Authority (HIQA) in Ireland has explanations of social care terms
• The University of Michigan in the USA has a plain language medical dictionary

Structuring our writing

We write directly to our readers to help them feel considered and involved. This means that we use ‘I’, ‘we’ and ‘you’ in our documents, where possible. For example:

We use the active voice to make it clear to our readers who is taking the action. For example:

We use verbs rather than abstract nouns. For example:

We avoid wordy phrases. Here are some examples:

We are concise. We keep sentences to 15 to 20 words on average. This improves our punctuation.

When structuring the text, we:

• consider the flow of our information and place it in logical order to make it easier to follow
• emphasise actions that people need to complete. For example, confirm an appointment
• consider what our readers are likely to think is most important, and make sure those points come first
• have no more than 1 topic per paragraph
• start with simple details - for example, time and place of appointment
• include a summary of the information or the takeaway messages at the end of our text
• provide links to further details

Designing our documents for print

Simple layout and design techniques make a document easier to read.

Font type and size

We use Arial in all our written information for simplicity and readability.

We aim to use a minimum of font size 12 point in the body copy of all our documents. We do not use less than font size 10 point in our documents.

Headings

We use headings to break up blocks of text. We use bold to emphasise our headings.

We use headings that are statements or questions. We avoid using one-word headings such as ‘Introduction’. Instead, use ‘About this document’.

Paragraphs

Our paragraphs are never longer than their width. Otherwise, we would have blocks of text that are difficult to read.

We add white space to a document using paragraph breaks and line spacing. This makes them easier to read. We usually include one or two sentences in a paragraph and aim to use a minimum of 1.5 line spacing.

Page breaks

We make sure that information is not broken up between pages. If you are starting a new section or paragraph near the end of a page, start it on the next page instead.

Italics and underlining

We do not use italics and underlining as it makes text more difficult to read.

Bold

We only use bold for headings. If we need to emphasise words or phrases, we:

• put the most important information first
• use bullet points

Sentence case

We use sentence case for headings and body text.

USING ALL CAPITALS makes text more difficult to read and looks harsh. Capitalising Each Word Makes Text Difficult To Read.

Bullet points

We use bullet points to break up long sentences.

Bullet points with no lead-in sentence

For bullet points with no lead-in sentence, start with a capital and end with a full stop.

Example:

Data and information are an integral part of the healthcare system.

• They are an essential support to the delivery of high quality, effective health and social care.
• Personal information must be handled appropriately, safely and securely.
• Relevant data helps us understand the needs of our population.

Bullet points with a lead-in sentence

For bullet points with a lead-in sentence, use lower case at the start of the bullet point. Introduce the list with a colon (:). We do not punctuate bullet point list items in digital content.

Example:

People like bullet points because they:

• are easy to read
• grab attention
• signpost what a page is about

In print, we put a full stop at the end of the list.

Charts, tables and images

Charts, tables and images can help people to understand information.

When creating them, we:

• make our charts and tables easy to read
• only use images, photographs, illustrations, infographics, graphs, tables and charts that are related to the text. They help us explain written information further
• only use relevant and appropriate images that are real, relatable and sympathetic to the reader
• use images that reflect our infection prevention and control guidance. For more information, see page 19 of the HSE Visual Identity Guidelines
• use images that are inclusive
• do not use images that reinforce negative or stereotypical attitudes
• add captions to our images, photographs, illustrations, infographics, graphs, tables and charts. We write them our captions in full sentences. They can be 2 or 3 sentences long

Copyright

We use:

• images that the HSE owns the rights to use
• free images with suitable licences

Consent

We get written consent from people before we publish their images. The HSE national Communications and Public Affairs Team has standard forms to get signed consent at HSE.ie/branding. Talk to your local communications team about these.

Techniques and resources we use to develop information

HSE Visual Identity Guidelines

We follow the HSE Visual Identity Guidelines. These contain important instructions such as using Arial font. The guidelines also tell us how to put the HSE logo on letterheads, documents and all our public information documents.

Developing and checking written documents with our intended readers

We ask intended readers (users) to give feedback when we are creating documents.

This ensures that our documents are written and presented in a clear way and follow our plain language guidelines for writing. It makes our documents easier to understand and follow.

Engaging with our users can include getting feedback on:

• finished documents
• draft documents
• the design and source material for documents

The best way to engage with users is to co-produce documents with them. This is not always possible.

We should, at the very least, ask users to provide feedback on the vocabulary, structure and design (colours, images and charts) of a draft text. We can ask them questions like:

• Is the document clear?
• Are there difficult words in it?
• What is the main message in the document?
• Does it give you all the information you need to know?
• How does the information make you feel?

Checking our information for readability

We can use online tools that check or calculate how easy it is to read written documents. They are not as good as checking with our users, as described above.

Some readability tools offer alternative words to complex ones and highlight complicated sentence structures. Others can grade your text (using school average reading ages and grades) and show you how to lower the grade.

It’s best to use these tools only for text that will be made public. Some of these tools are not appropriate for confidential or sensitive information. Check the terms and conditions of the tool before using it.

NHS Medical Document Readability Tool

The NHS app is a free online readability tool. You can copy and paste your text into it.

The tool:

• checks your writing (but not your spelling)
• calculates the age someone in the UK would need to be to read and understand the text
• estimates the average time it takes to read the text
• highlights complex sentences and words and passive verbs
• counts the average words per sentence and sentences per paragraph

NHS Document Readability Tool

Drivel Defence

The Drivel Defence app is a free online readability tool. It was developed by the Plain English Campaign in the UK.

The tool:

• checks your writing and spelling
• offers plain language alternative words to difficult words
• counts the number of sentences
• counts the number of words in sentences
• highlights sentences with more than 20 words

Drivel Defence app

Hemingway Editor

The Hemingway Editor is an online readability tool. It has a free version. You can copy and paste your text into it.

The tool:

• highlights sentences that are very hard to read and hard to understand
• highlights the use of passive verbs and adverbs
• provides alternative words to difficult words
• gives you a word count
• calculates the age someone in the US would need to be to read and understand the text

Do not paste any sensitive, confidential, unverified statistics or embargoed information into Hemingway. Any text pasted into Hemingway is accessed by its artificial intelligence (AI) model and can be made public

Hemingway Editor