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Website content (text, links, images, attachments, videos etc.) must be accessible to all users, including disabled people.

Below are simplified rules to help users when providing us with new content; please refer to WCAG 2.1 guidelines for complete rules.

Please note that it is the responsibility of the creator to ensure that all documents posted on our website (images, PDFs, presentations, videos etc.) are accessible.

Images

UK Government published guidelines for images: how to choose and describe images, use alt text, produce accessible graphs, diagrams and infographics

  • Images must have a meaningful text alternative (description) that provides the same information presented in the image. Alt text should be specific and succinct, describing information, not aesthetics; general recommendation for alt text length is 125 characters.
  • Images that include text as part of the image must have a suitable text alternative, with the exception of logos
  • Infographics and charts must have a link to a full description of the content; the alternative text should describe where the description is.
    Note: pie charts need to display colours readable in black and white; colours may be complemented with texture; alternative text for a pie chart may be a simple table (with a header row and no merged cells)

Links

  • Links must use some text that is meaningful out of context: users of screen readers must be able to understand the link without reading the surrounding text. Avoid 'click here', ‘more’ and 'read more' as they are ambiguous and make no sense out of context.
  • The text for links should be descriptive for where the link will go.
  • Links should not typed out in full (starting with http or www), but instead be embedded within text: screen readers read out URLs character by character.
    Note: short URLs (such as homepage) may be used as the link text
  • All links must open in the same browser window
  • Avoid using anchor links

Documents

As much as possible, documents should be published in HTML format and not PDF (see the section on webpages below).

Text documents

Word documents and PDFs must be fully accessible

  • Keep the document structure simple
  • Use a sans serif font like Arial or Helvetica, with a minimum size of 12 points
  • Text should be left aligned, not justified: justified text creates readability issues for people with dyslexia and other conditions that affect reading and comprehension
  • Give the document a meaningful and informative title and hierarchical headings
  • Do not use heading styles to highlight information
  • Use bold text as little as possible, and not as a substitute for headings
  • Do not use bold, underlined or all caps to draw attention to a word or sentence.
  • Do not use colour as the sole way to convey important information
  • Images must follow the rules stated above
  • Links must use text that is meaningful out of context (see above), and not typed out in full
  • Run your final document through the programme’s accessibility checker before converting to PDF
  • Manually check the reading order

In addition to those recommendations, please follow our guidelines Writing for the web (NDM SharePoint, accessible with SSO): writing to be read, how to make your text easier to read (short sentences and paragraphs for example)

Acrobat Pro offers tools to create accessible PDFs and check the accessibility of existing PDFs.

In Acrobat Pro, navigate Tools -> Action Wizard -> Make accessible

This procedure allows to add a title, author, language, any missing alt text for images etc.

You can also use Kofax Power PDF to check a PDF for accessibility

Note: if you are posting an elaborate PDF (with multiple image at various sizes including in the backgroud, more elaborate structure etc.) it might be difficult to make the document accessible, in particular the reading order.
A possibility is to create a simpler document with text only, no images and a straightforward structure, and post this document as an alternative for accessibility. See for example the NDM-CGHR brochure on the NDM-CGHR page

Tables

Tables must follow the recommendations for text documents

Additional recommendation for tables:

  • Tables should include a header row if users need it to understand the content of each cell, in relation between the cell and the header row; headers should not be visually communicated by formatting the text using size or colour
  • Empty cells within a table should be marked as such with a minus sign, a zero or N/A
  • Avoid merging data or header cells; merged cells cause navigation problems

Presentations

Presentations must follow the recommendations for images, links, text documents and tables

Additional recommendation for presentations (either powerpoint or PDF)

  • Use unique slide titles, to allow screen readers to skim slides to navigate. Using the layout options in PowerPoint rather than adding text boxes to a blank slide ensures screen readers can recognise titles.
  • Make hyperlinks, images and tables accessible: see recommendations above
  • Set reading order of slide content, this is particularly important if there are more than one text box. Screen readers read the elements of a slide in the order they were added in, which might be different from the intended order.

Video and audio

  • Videos and audio must have transcript and captions
  • Video or animation must not have content that flashes more than three times a second

Web pages

Web pages must follow all rules stated above; below is a quick summary how to make web pages accessible

Structure

  • Web pages must have a unique and meaningful title, as well as hierarchical headings
  • Heading styles must not be used to highlight information
  • Bold text should be used a little as possible, and should not be used as a substitute for headings

Images

  • Images must have a meaningful text alternative (description)
  • Images that include text as part of the image must have a suitable text alternative, with the exception of logos
  • Infographics and charts must have a link to a full description of the content

Tables

  • Tables must include a header row if users need it to understand the content of each cell, in relation between the cell and the header row.

Links

  • Links must use text that is meaningful out of context (see above)
  • Links must not typed out in full, but instead be embedded within text
  • All links must open in the same browser window

More information

You can find more information on the pages for Accessibility training and support on the MSD website

The University of Oxford posted guidance how to create accessible documents

Detailed guidance how to publish accessible documents is posted on the UK Government website

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