Supporting patients and the public to inform and influence the provision of services

We use regular patient, carer, professional and stakeholder communication, engagement and feedback to continue delivering a patient centred approach that traverses organisational boundaries, enabling seamless patient care. We have invited patients into our call centres, meeting staff and making their own observations. This approach has generated patient advocates who are knowledgeable about the service and tell others.

Through delivering services across demographically diverse counties, we are aware of language and cultural barriers and how to address them. We are experienced in providing healthcare services to communities where English is not their first spoken language. We provide interpretation services across all of our services, either telephone-based or in our Primary Care Centres. Health Advisors will identify a patient’s interpretation needs when they capture demographic data. We then contact Language Line and have a three-way conference phone call, ensuring the caller can give a true account of symptoms. If directly booking patients into another service, any language requirement is clearly flagged on the referral. We proactively recruit staff to reflect local communities and demographics of the population.

We recognise the role of Healthwatch as an independent consumer champion for patients. Healthwatch provides us with information about key aspects of their work that presents opportunities for us to engage with vulnerable communities for example, Gypsy, Romany and Traveller communities.

As a Social Enterprise, our ‘membership’ is drawn from all parts of the community. This enables us to be uniquely positioned to engage with all communities.

Accessibility FAQs

Patients who are blind or can't see very well (Windows)

Step-by-step guide on how to use Narrator, the built-in speech function in Windows 7

Turn on and customise Narrator

Step 1: Use Narrator now

Open the ‘Ease of Access Center’ window by pressing the Windows key + U, or by clicking the ‘Start’ button, followed by ‘Control Panel’, then ‘Ease of Access’, then ‘Ease of Access Center’.

Under the ‘Quick access to common tools’ header, click ‘Start Narrator’, or press Alt + N. This will start Narrator for current use.

Step 2: Set Narrator to start every time

Follow these steps to make Narrator start automatically when you log in.

Open the ‘Ease of Access Center’ window as in Step 1. Under the ‘Explore all settings’ header, click on ‘Use the computer without a display’, or press Tab until it is highlighted and then press Enter.

Under the ‘Have text read aloud’ header, tick the box next to ‘Turn on Narrator’, or press Alt + U to tick it.

Click the ‘OK’ button, or press Tab until it is highlighted and then press Enter.

Step 3: Tell Narrator what to read

Once you have turned on Narrator, you can select which things Narrator will read aloud.

If you want text to be read aloud as you type, tick the box next to ‘Echo User’s Keystrokes’ by clicking on it, or press Alt + K to tick it.

If you want to have system messages read aloud, tick the box next to ‘Announce System Messages’ by clicking on it, or press Alt + M to tick it.

If you want to hear screen scrolls, tick the box next to ‘Announce Scroll Notifications’ by clicking on it, or press Alt + N to tick it.

If you want the settings box minimised at start-up, tick the box next to ‘Start Narrator Minimized’ by clicking on it, or press Alt + Z to tick it.

When you are finished, minimise the settings window by clicking on the ‘Minimize’ button on the title bar, or press Alt + Spacebar and then press N.

Note: If this does not work it could be because your computer settings cannot be changed due to local IT policies – contact your local IT support for further help.

Step 4: Keyboard shortcuts in Narrator

To read text from a screen, use the following shortcuts when Narrator is running.

Insert + F3 – Read the current character.

Insert + F4 – Read the current word.

Insert + F5 – Read the current line.

Insert + F6 – Read the current paragraph.

Insert + F7 – Read the current page.

Insert + F8 – Read the current document.

Patients who are blind or can't see very well (Mac)

Step-by-step guide on how to use VoiceOver, the built-in speech function in Mac OS X

Turn on and customise VoiceOver

Step 1: Open the ‘Universal Access’ window

Make sure you are in ‘Finder’. If necessary, press Apple + Tab to cycle through the open applications until you return to ‘Finder’.

Click on the ‘Apple’ icon on the menu bar or press Ctrl + F2.

Click on ‘System Preferences’ or press the down arrow key to highlight it and then press Enter.

In the ‘System Preferences’ window click on the ‘Universal Access’ icon, or press Tab repeatedly (you might need to press Ctrl + F7 first) to cycle through the icons until the ‘Universal Access’ icon is highlighted and then press the Spacebar.

Step 2: Turn on VoiceOver

In the ‘Universal Access’ window make sure the ‘Seeing’ tab is selected. If it is not, click on it, or press Ctrl + F7 to highlight one of the tabs and then press the left or right arrow key to select it.

Under the ‘VoiceOver’ header, click the ‘On’ radio button, or press Tab until the ‘Off’ radio button is highlighted and then press the left arrow key to select ‘On’. You can also turn VoiceOver on or off at any time by pressing Apple + F5.

Step 3: Customise the settings for VoiceOver

To change the VoiceOver settings, click on the ‘Open VoiceOver Utility’ button, or press Tab until it is highlighted and then press the Spacebar.

In the ‘VoiceOver Utility’ window you can customise the settings in nine categories, which appear in the left-hand pane.

To select a category, click on it, use the up and down arrow keys, or press Apple and the number it is in the list. For example, for ‘General’ press Apple + 1 and for ‘Braille’ press Apple + 9.

For a detailed guide to all of the VoiceOver settings options, see Apple’s VoiceOver pages.

Click on the window’s red close button or press Apple + W to finish.

Note: If this does not work it could be because your computer settings cannot be changed due to local IT policies – contact your local IT support for further help.

Step 4: Braille support in VoiceOver

VoiceOver includes braille support. VoiceOver automatically recognises the model in use and programmes the keys – including ‘wiz wheels’, scrollers, router keys and buttons – to best suit each model’s characteristics.

If you don’t have a USB braille display, you can use the on-screen visual braille panel that is included with VoiceOver.

The braille panel behaves like a standard 40-cell display. It shows both the braille dots being sent to the dedicated braille display and an English translation, so sighted instructors, parents or co-workers can read its contents with minimal disturbance to the non-sighted user.

Patients who may find words difficult

Changing the font size

You can change the zoom on your computer, which can help you if you have low vision and need larger font sizes.

On a PC, using Internet Explorer: please select the settings menu at the top of your window, scroll down and select the Zoom option.

On an Apple Mac: from Safari select Preferences from the Edit menu at the top of the window. From there, click on Web content and uncheck the Show style sheets option. Then return to the list of preferences and choose Web browser. Then click on Language/fonts and choose the size you need.


Changing the text colour

You can change the colour of the used fonts on your screen. This may be useful for you if you have low vision and need high contrast colours. You can change the style and colour, and choose an alternative colour for links. You can also change background and foreground colours.

To ignore font and background colours in Internet Explorer on a PC, choose Internet options from the Tools menu at the top of the window. On the general tab of the window that appears, click the Accessibility button. This takes you to a menu where you can choose to ignore the way the page is formatted. To set your colour and font preferences, return to the Internet options menu and use the Colours and Fonts buttons.

Patients who may find a keyboard or mouse hard to use

Navigating this page using your keyboard

You can use your arrow keys to scroll up or down the page. To move in between links,  use your Tab key and press Return or Enter to select one. To go back to the previous page, use the Backspace key.


Navigating this page using your mouse

Your operating system should allow you to change the speed of the mouse, adjust the amount of time needed for double-clicking, and swap the functions of the buttons for left-handed use. Depending on the type of mouse you have, you may also be able to customise other features, such as:

  • changing the acceleration of the mouse pointer
  • forcing it to only move horizontally and vertically
  • changing the functions of the available buttons (and scroll wheel)
Advice on downloading documents

We try to make sure all our pdfs on the HUC website are accessible. If you are having problems accessing a particular document, please let us know at The Adobe website has advice on accessibility within the Adobe suite itself.

Documents downloadable from the HUC website will usually be in pdf format, but can be provided in an alternative format (Microsoft Word or Excel) on request. Most computers already have the software to open a pdf document. If you do not have Adobe Acrobat Reader (for reading PDFs), it is available from the Adobe site.

To save the document on your PC, you need to right click on the link to the document. If using a Mac, please hold down the mouse button over the link. For both PC and Mac, a popup menu will appear, please click on ‘Save target as’. You will then be asked to choose a folder on your computer where you can save the document.

Some browsers such as Firefox and Chrome automatically download documents to your computer when you open them.

Advice on accessing videos on our site

You can request a text alternative to any videos featured on the HUC website that do not include closed captions by contacting Please let us know which video you would like information about.

Patients and Sensory Impairments

We give staff extra time to complete assessments and include sensory impairment as inclusion criteria for home visits, if a telephone assessment or access to a primary care centre poses challenges or barriers to accessing the service. At the end of every assessment, the staff member will highlight to the appropriate onward referral service if any adjustments are required.

We provide Next Generation Text Services for those who are unable to use a standard telephone. Through engagement with Healthwatch Hertfordshire, we became aware of the difficulties people who are hard of hearing had with accessing NHS 111 services, and subsequently developed links with the charity Signhealth, lobbied NHSE over access issues, directly leading to the British Sign Language video relay pilot and subsequently the launch of a tablet/smart-phone version of the service.

Patients with Known Mental Health Problems

Staff are trained to recognise Mental Health problems, and have regular Dementia training. To gain a more in-depth understanding, they have visited a local Mental Health service, allowing them to show empathy whilst remaining professional at all times. For those patients who require further support, the Health Advisors will warm transfer to the MCAS, those with an SPN will be re-directed automatically to the specialist.

Patients with Acute Mental Health Problems

In line with the Mental Health Concordat for Crisis, we treat a mental health emergency in the same way as we treat a physical health emergency, and respond to both to prevent deterioration and manage the crisis. We are developing 24/7 pathways to Mental Health specialists within our MCAS model.

Useful Links for Patients with Mental Health Problems

Hertfordshire Partnership University NHS Foundation Trust is committed to providing health and social care for people with mental ill health. The trust also offers a range of telephone services.

NHS Choices has information about mental health problems on their Moodzone page as well as information for young people experiencing mental health issues.

Mind offers a range of telephone support services for those in need of guidance.

Patients who are deaf or who may need assistance with NHS 111

NHS 111 British Sign Language Service operates 24/7, and can assist you by telephoning an NHS 111 Health Advisor and relaying your call.

One of our Health Advisors will assess your emergency in partnership with an interpreter.

In collaboration with a BSL Interpreter, we will be able to work with you to ensure that your questions are answered and you are connected with the care you need, when you need it, where you need it.

Find out more about the NHS 111 BSL Interpreter Service.

At HUC, respect for our patients is embedded in our company values. We endeavour to make every reasonable appropriate adjustment to ensure our service is accessible for all patients.

If you have any issues accessing this website, please let us know at Please note that we cannot guarantee the accessibility of third party websites, documents and multimedia content that we may link to.


Read our Accessible Information Statement.