Disproportionate burden assessment: specialised commissioning

As of September 2018, accessibility legislation states that public sector websites must publish content in an accessible format. This means making our website content ‘perceivable, operable, understandable and robust’. You can read more about how our website complies with this regulation in our accessibility statement.

We publish specialised commissioning information that includes service specifications and commissioning policies.

Service specifications define the standards of care expected from organisations funded by NHS England to provide specialised care.

A commissioning policy is a document that defines access to a service for a particular group of patients. These documents ensure consistency in access to treatments nationwide.

Our specialised commissioning document library has been published on our website in PDF format. This format may not be fully accessible to users of assistive technologies.

Assessment outcome

We have assessed the requirements for providing this information as web copy (in HTML) and have come to the conclusion that to do so presents a disproportionate burden for the following reasons:

Target audience

The audience numbers for specialised commissioning documents are often very small. For example, Barth Syndrome Service (Children) – service specification has been accessed by 8 users in the 8 months between July 2023 and March 2024.

Cost and volume of resource to produce

There are hundreds of existing service specifications and policy documents and these are regularly updated. They are typically between 10-30 pages in length. Converting the existing PDFs to HTML would require external web support at significant cost to NHS England. Supporting the maintenance of web-based documents would also need ongoing additional team resource.  

Benefit of greater accessibility

We will publish new specialised commissioning service specifications and policy documents in PDF format. We will acknowledge the limitations this may cause to users of assistive technologies and will provide users with a contact to request alternative formats.  

How long this assessment will apply

This assessment is likely to apply until the work to develop a new NHS England website is concluded and web content resource is increased. Discovery work on this project started in March 2024.

Reasonable adjustments

Under the Equality Act 2010 or the Disability Discrimination Act 1995 (in Northern Ireland) we will make reasonable adjustments for people who need information in a more accessible format. You can find out more about reasonable adjustments in our Accessible Information Standard.