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There has been a lot of discussion recently about PDFs being "inaccessible" and not compliant with the WCAG regulations.  We have written this guidance in response to a number of our clients asking us for support in this area.

Are PDFs Accessible? 

The WCAG requirements (2.2 now) don't apply only to websites, but to all ‘web content’ - hence its relevance to documents, videos and other files which are hosted and viewed on the web.  PDF files (and other lesser mentioned documents, such as Word) aren't fundamentally inaccessible. They are in fact just like webpages – in that they are only as accessible as they are made to be.

Much like web pages, documents have semantic elements (meaning an element which describes what it is, in code, or to screen reader for example) - which aid their accessibility. Where you have a semantic heading on a web page, you can also have a semantic heading in a PDF or Word document. This enables assistive technology like screen readers, to skip through the document.  There are also links and images, both of which can be given similar background text to aid assistive technologies.   For information see our Accessible Content Guide.

So PDFs can be accessible?

Yes, BUT

The issue with most PDF files is that:

  1. They date back years and haven’t been renewed since;
  2. They were either not made with accessibility in mind, or haven't always been updated along with the guidelines 
  3. In most cases they are therefore not formatted correctly (e.g. links/headings)

So PDFs are often inaccessible in many of the same ways that an old or poorly edited webpage would be inaccessible.  There is no specific requirement for PDF documents to become webpages, provided they are formatted correctly.  

Documents can be provided accessibly - and if a PDF document is edited to tick all of the boxes set by the guidelines, there's no issue with it existing on your website.  For more information, see the Documents section on our Accessibility page.  However, many of our clients find that they do not have the skills, knowledge or time to make these PDF documents fully accessible.  NHS Digital have also written about this on their accessible PDFs page.  Adobe Pro for example, has built in tools to help clients make PDFs accessible, but any tool will still require someone to go through and edit it. 

Therefore, there is a trend towards information in documents being moved over to webpages.

Why use webpages?

The web is the primary way that a lot of people interact with information; we are familiar with it. To a lot of people, including those who use assistive technologies, it will be easier to navigate a well-made webpage than a PDF document.

Webpages also come with many other benefits:

  • They’re already designed to your organisation’s style
  • If they’re on the same site, a user doesn’t have to leave the site to open them
  • They’re responsive, meaning that they work just as well on mobile devices as they do desktop ones
  • For Frank sites, the user can translate the page using the translation tools, this can save the Trust money on translation costs
  • For Frank sites, users can use the tool bar to increase the font size and change the colour contrast meaning it is more readable for people with visual impairments
  • For most editors, they are a little easier and more familiar to edit than PDF documents
  • They can include better features such as interactive forms, accordions, videos or design features etc.

How can we move to webpages?

There is an element of automation which can be done – Frank are working on a tool which will take text and images from PDF documents, and turn them into standalone webpages.  However, it will still require human intervention to manage the formatting – the main reason that PDFs are an issue to begin with. 

There is no way to take poor formatting and automatically turn it into good, or even great formatting – that requires human input.  You need to make sure that you set the correct headings which requires an understanding of context.  Furthermore, you need to ensure links and images area added and have relevant title and alternative text, as well as create the correct ordered or unordered lists – and so on.  For further examples of common formatting issues – see our Accessible Content Guide.

How can Frank help?

Patient information leaflets

Patient information is a common area which Trust's wish to prioritise for conversion to webpage.  Frank can support clients in the following ways: 

  • Library - if a client is going to convert their leaflets over a period time, we will build a hybrid search function that combines leaflets and pages as per this example on the Royal Free website.  This is a listing with keyword search and filter options, displays both pdfs and webpages, with an icon to indicate the format.  
  • Page type - we create a patient leaflet page type with an attribute which links to PDF leaflet.  If no web content is added to the page, then the user is redirected to the leaflet.   The page can also be linked to a Service page and have standardised text as per this example.
  • Print this page – we can also build a “download or Print” button which will strip out unnecessary information (e.g. navigation menus) and print out URLs (e.g. for videos / links) – clean print with logo. We can also add an automated date for “date saved/printed” with an advisory message.  The page can then be translated and saved as a PDF, or printed and provided to a patient.
  • Import - we can import a spreadsheet (CSV) of the patient leaflets to create all of the pages in the CMS (required for creating the library in the first point).  This can also match the associated document to the page, and apply any relevant attributes to be displayed on the page (e.g. review date, version number).
  • Conversion from PDF to HTML – Frank can do this on behalf of the client.  This includes – adding alternative text to image, amending formatting issues (e.g. additional hard returns & lines breaks that appear when you copy from pdf), assign semantic headings, ensure that links are added correctly, add video embeds instead of links etc.  Where the subject matter is particularly clinical and complex, Frank may request the client reviews the page to ensure the Headings are assigned appropriately. In the case of detailed medical illustrations, Frank request that the client provides alternative text.

Digital presentation of key documents

This is used for large, important documents such as a Digital or Clinical Strategy. Frank can support clients in the following ways: 

  • Creation of a page template as per this Digital Strategy example.  This can include:
    • ​​​​​​a bespoke design (this can be tailored to the client’s requirements)
    • side bar navigation element
    • back/next buttons
    • featured content boxes
  • Conversion from PDF to HTML – as above

Next steps 

If you are ready to consider converting some of your PDF documents, you can consider the following questions:

  • Patient information leaflets
    • how many leaflets do you have?
    • how many would you want converting by Frank? 
    • would you need the hybrid library or will you convert them all in one go?
    • do you have a central spreadsheet or document management system which captures all the information that could be used for an import?
  • Other digital documents
    • do you require the page template and design?
    • Would Frank undertake the conversion as well? If so, we would want to see the documents to accurately assess the time required to amend them.

If you have any further questions or are ready to take the next step, please feel free to contact Frank via Support or your Account Manager.