NHS inform style guide

The voice of NHS inform content should be consistent across all NHS inform products and services. It should be straightforward, active where possible, and accessible. The tone will differ across the site as follows:

• Self-management (regarding illnesses, conditions and symptomatic queries) – Reassuring, supportive and authoritative (Characteristics – nurse / teacher)
• Prevention (regarding healthy living, lifestyle advice and preventative measures) – Friendly, motivational and upbeat (Characteristics - personal trainer / motivational speaker)
• Anticipation (regarding identification of common characteristics, health risks and benefits and life stages) – Encouraging, reassuring and supportive (Characteristics - peer to peer)

Plain English

NHS inform is for everyone in Scotland. Plain English makes our content as accessible to as many people as possible. We've a public service remit to reach as many people as we can. All audiences should understand our content. It’s not about ‘dumbing down’ – it’s about making public services in Scotland easily accessible by all.

Words have to be appropriate and not too vague or they can lead to misrepresentation. Avoid using jargon, whether in the form of specific words or in an overly complex sentence structure.

Even as adults, we find a core of 2,500 to 5,000 common words easy to recognise and understand. If you write in plain English, thinking of the reading age of a child of 9 years old, your English will be accessible to most of your users. When you use a longer word (8 or 9 letters), users are more likely to skip shorter words that follow it (words of 3, 4 or 5 letters). Use longer, more complicated words, and readers will skip more.

Example

'The recently implemented categorical standardisation procedure on waste oil should not be applied before 1 January 2014.'

You can imagine people missing that ‘not’, which would be a big deal. Instead, write:

'Don't use the new waste oil standards before 1 January 2014.'

Don’t use formal or long words if easier or short ones will do and avoid metaphors. We can generally get rid of any long words or metaphors by breaking the term down into what you’re actually doing. This makes our content easier to understand and avoids confusion.

Search for guidance on style and punctuation using the alphabet below to jump to the relevant letter.

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

A

Abbreviations and acronyms

Mr, Mrs, Dr etc don't take a full stop at the end.

You can use an acronym to replace a name or term that appears frequently in a single content item. Don’t include an acronym unless you'll use it several times later on in the same text.

Spell out the acronym in full the first time it's used, putting the acronym in brackets immediately afterwards - for example Abdominal Aortic Aneurysm (AAA). Don’t use full stops in acronyms – AAA, not A.A.A. From then on, use only the acronym in that specific content item.

There’s no need to spell out acronyms in common usage - for example DVLA, EU, HMRC, MSP, UK, USA, VAT. This includes government departments and schemes.

Ages

Ages are given between commas – for example John Smith, 32, a doctor (not 'aged 32').

Fertilised egg = from conception to 14 days

Embryo = from 2 to 9 weeks

Unborn baby = from week 10 to birth

Baby = 0 to 12 months

Infant = less than 2 years

Toddler = 1 to 3 years

Child = 1 to 12 years

Teenager, young person = 13 to 19 years – don’t use pubescent or adolescent

Older people = 60 to 70 years – don’t use old age pensioner, pensioner, OAP or the elderly

Elderly people = over 70 years, although if possible don't use elderly

Hyphens for age ranges, rather than en dashes or use 'to'.

Ampersand

Ampersand (&) symbol should only appear in the logo image of an organisation or department, or in a page title. Always use ‘and’ in headers, subheaders and body copy.

Apostrophes

Use for plurals - for example 'Choices' style guide' and not 'Choices's style guide'.

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B

Bold

Use only sparingly.

Brackets

See parentheses.

Bulleted lists

Make sure that:

• you always use a lead-in line ending with a colon
• all of the bullets make sense following on from the lead-in line
• you use lower case at the start of the bullet
• you don’t use full stops within bullet points – where possible start another bullet point, or use commas or dashes to expand on an item
• you don’t put ‘and’/‘or’ after any bullet, although there may occasionally be a need
• if you add links, they appear within the text and not as the whole bullet
• there's no full stop after the last bullet point
• your bullet points are all in the same tense and verb form, with any common information in the lead-in
• if you need to use complete sentences, start with a cap and end with a full stop for each line, and make sure each are complete sentences (but use this type sparingly)
• lists are consistently phrases or sentences – don't combine style in one list

You can use numbered steps instead of bullet points to guide a user through a sequential process. Each step ends with a full stop because each step should be a complete sentence.

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C

Capitals

Words should be capitalised as follows:

• initial caps for organisations/projects/initiatives – for example Getting It Right for Young Carers strategy, National Care Standards, the British Museum, the National Gallery, the Royal Albert Hall, the Tate Modern (except for the...a, an, and, at, for, from, in, of, the, to.) 
• initial caps for acts – for example Integration (from Public Bodies (Joint Working) (Scotland) Act 2014), but lower case for 'act' on its own, and legal concepts – for example power of attorney
• publications – The Phantom of the Opera, but newspapers drop the initial cap for 'the' -for example the Guardian and the Times
• titles of websites – use the capitalisation as the website does, even if this is contrary to our capitalisation rules

The exception to caps for organisations is where they use the lower case themselves - for example npower.

Colons

Use a colon to introduce a list of bullet points. Never use semicolons. For use of dashes see below.

Commas

'I like chocolate, cakes and puddings.' Use the Oxford comma only for complex sentences or to prevent confusion.

Examples of complex sentences

Find out information about holiday entitlement or sickness absence, calculating leave, and disputes.

I like cheese and ham, cheese and tomato, and cheese and pickle sandwiches.

Use to separate clauses – 'If you're in Scotland, prescriptions are free of charge.' And 'He had chicken pox, but his sister didn't contract it.'

Use for subordinate clauses – 'Tremor, which normally begins in one hand or arm, is a symptom of Parkinson’s disease.'

Contact information

Be consistent in offering contact info in links (phone number, for example). It should be in this style: Phone 0300 000 0040, Monday to Friday, 9am to 5pm.

Contractions

Try to use contractions consistently when writing. There are instances where contractions aren't suitable - use your common sense when deciding on appropriate use.

Who are to who're isn't an appropriate contraction. 

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D

Dashes

En dashes, not hyphens, can be used for subordinate clauses, in place of parentheses or commas. Always put a space before and after. A dash should be used in place of a colon if introducing a call to action or a list but not if this would be better realised with a bulleted list. A dash is less formal and can help the content flow better.

Examples

You can fill in the form – paper or online version – to tell us about a change.

It’s important to tell us about any changes immediately – so act now.

You should never use em dashes (—).

Dates

When writing dates, use the format - 14 June 2015.

Don't include 'the' definitive, or a 'th' after the day.

Disability

Always use positive language about disability. Don't use outdated terms that stereotype, stigmatise, label or depersonalise. See GOV.UK’s words to use and avoid when writing about disability. You could also visit the Scottish Commission for Learning Disability website.

Don't use:

• afflicted by
• sufferer
• suffering from
• victim of
• struck down by
• handicapped
• invalid
• spastic
• cripple
• sufferer

Use:

• people living with
• people with
• person with
• disabled person
• person with a mental health problem
• person with a mental health condition
• person with a learning difficulty

Autism

There’s an exception to the person-first language rule when writing about autism. Most autistic people prefer to be referred to using identity-first language – for example:

• autistic people
• autistic person
• someone who is autistic

Use the above language when writing about autism.

Deafness and hearing loss

When writing about deafness and hearing loss, don't use:

• impairment
• impaired
• D/deaf

Use:

• deaf
• deafness
• hearing loss
• deaf and hearing loss

When writing about British Sign Language (BSL), don't use:

• deaf BSL users
• language that suggests only deaf people or those with hearing loss use BSL

Use:

• BSL users

Accessibility services

When describing accessibility services available, avoid describing who might use the services with language which may exclude or offend. For example, describing BSL services as being for people who have deafness or hearing loss.

Don't use:

• If you have difficulties hearing or communicating you can call NHS 24 (18001 111) on a textphone.

Use:

• If you use a textphone you can contact NHS 24 on 18001 111.
• You can contact NHS 24 by textphone on 18001 111.

Disease, sickness and illness

Disease, sickness, illness are OK, but prefer condition.

Don't use:

• sick person
• the sick
• the ill
• diseased
• disease carrier
• special needs (as in 'a special needs person') but bear in mind that some people do have defined 'special needs', for example someone with a statement of Special Educational Needs

Use:

• specific need(s)
• individual need(s) but note caveat above.

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E

Exclamation marks

Exclamation marks - are almost always unnecessary! If you absolutely have to, never use more than one!!

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F

Fractions and percentages

Spell out common fractions like two-thirds. For percentages, use the % symbol - for example, 50%. However, it's often better not to use a percentage. Instead of 50%, for example, you could say "1 in 2" or "half".

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G

Gender neutral language

Use gender neutral and inclusive language such as 'they' and 'them' throughout all content.

When referencing specific body parts, use, for example 'women and anyone with a cervix' or 'men and anyone with a prostate'.

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H

Health Boards

Use ‘local health board' lowercase unless referring to a specific board.

Specific health boards should have capitals at the start of each word. For example, NHS Western Isles.

When ‘and’ is used in a health board, this should be written as a word. The symbol ‘&’ should not be used. For example, NHS Greater Glasgow and Clyde.

Hyphens

Use hyphens for phrasal adjectives that come before the object - for example 'quality-assured website', but 'this website is quality assured'. Adjectives after the noun should not be hyphenated – 'The boy was 14 years old', 'the gap was five miles wide'. Nor should there be hyphens between adverb and participle – poorly written prose, highly charged drama, badly performed surgery (but well-chosen words).

As English evolves, compound adjectives often become single words – bloodstained, overblown, underdone, redheaded, half-hearted. This is also true of compound nouns – steam ship became steam-ship then became steamship; machine gun became machine-gun, and now is machinegun. In general, favour the hyphenless form. It's neater and punchier.

Avoid clashes of letter (redeye, but blue-eyed). Don't hyphenate words with the prefix re, except to avoid a clashing e (re-elect) or a visual snare (re-ignite), or to distinguish two meanings (reform, re-form; re-creation, recreation).

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I

Italics

Don't use them.

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M

Medical spellings

Conditions are spelled in lower case, except for use of proper names - for example Alzheimer's disease.

Conditions described in abbreviated/acronym form, like AIDS and HIV, don't take full stops after the letters.

Avoid medical jargon and technical terms as far as possible. If you must use them, explain them. Put the common terms first, for example 'flu (influenza)' rather than 'influenza (flu)'.

Medicines

The reference work for all medicines spellings is the British National Formulary. You have to register online, but it's free and is updated monthly. Generally, use the generic (scientific name) first followed by the brand name with an initial cap and in brackets - for example atorvastatin (Lipitor). Lower case for generic and upper case for brand name.

Once medicines have lost their patent protection, there may be rival branded generics that have a brand name and ordinary generics that use just the generic name. So in some cases, there may be several brand names.

Example, the asthma drug salbutamol has Airomir, Asmasal. Salamol Easi-Breathe, Salbulin Novolizer and Ventolin brand names as well as the generic name. In cases such as this give the best-known brand name, but indicate there are several – salbutamol (brand names include Ventolin). Some medicines have no brand names in use – examples include warfarin and hydrocortisone.

A handful of medicines are so well known by their brand names that it would be perverse to refer to them first by their generic name. The best known example of this is probably Viagra. In such cases give the generic term in brackets – Viagra (sildenafil).

Mental health

Don’t use:

• mental handicap
• mentally ill
• madness
• backward
• retarded
• victim of
• suffering from
• afflicted by
• slow and other outdated terms.

Use:

• a person with mental health problems
• people with learning difficulties
• mental illness
• mental health condition

Other common mistakes

• 'schizophrenic’ or 'bipolar' shouldn't be used to mean ‘two minds’ or a ‘split personality’
• somebody who's angry is not ‘psychotic’
• a person who's down or unhappy isn't the same as someone experiencing clinical depression

Don't use	Instead try
‘a schizophrenic’ or ‘a depressive’	someone who ‘has a diagnosis of’ is ‘currently experiencing' or ‘is being treated for…‘
‘the mentally ill’, ‘a person suffering from’ ‘a sufferer’, a ‘victim’ or ‘the afflicted’	‘mental health patients’ or ‘people with mental health problems’
'prisoners’ or ‘inmates’ (in a psychiatric hospital)	‘patients’, ‘service users’ or clients
‘released’ (from a hospital)	‘discharged’

For mental health terminology, see Time to Change or visit See Me Scotland.

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N

Numbers

Write all numbers in numerals (including 1 to 9), except where it’s part of a common expression and it would look strange - for example ‘one or two of them’. Use common sense. 

• 1,000, 2,000
• 500 to 600 (ie not a dash)
• ordinal numbers – spell out first to ninth. After that use 10th.
• in tables, use numerals throughout

Don't begin a sentence with a number that is not written out unless that number is a date.

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O

Organisations

Use the singular form of a verb – 'CIS is a service...' and not 'CIS are a service...'

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P

Paragraphs

Text should contain plenty of paragraph breaks. Keep paragraphs short and aim for no more than 3 sentences. New paragraphs don’t have to be for new subject matter, and it’s OK to have a one-line, one-sentence paragraph. You should aim to communicate just one idea per paragraph.

Parentheses

Use sparingly. Dashes are better for web content, but only use for one aspect of a sentence. When they contain a whole sentence, final punctuation falls within the brackets, otherwise it's outside.

PDFs and other documents

Include (PDF 358.7 KB), (DOC 1.7 MB) or (ZIP, 40 MB). Only quote up to 1 decimal place and always open documents in a new window. 

File sizes should have a space between the number and the measure. Measures should always be expressed in capitals, for example KB instead of kB.

People

Refer to 'people' (ie not 'men' or 'women') unless you have to medically, to prevent discrimination against transgender people. Use gender-neutral words whenever possible – use ‘them’, ‘their’, ‘they’ if not using ‘you’.

Phone numbers

Use the word phone (not call or telephone), as both verb and noun, and quote the number in one of these formats (but follow how the organisation would style its number if not as below):

• 01273 800 900
• 020 7450 4000
• 0800 890 567
• 07771 900 900
• 077718 300 300
• +44 (0)20 7450 4000
• +39 1 33 45 70 90

Positive form

Replace a negative form with a positive one wherever possible.

Examples

not able / unable

not available / unavailable

not forget / remember

not omit / include

not pay attention to / ignore

not possible unfeasible/impossible

not sure / unsure

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Q

Quotation marks

Use single quotes for unusual terms that require explanation but use sparingly. Don't use for titles of publications or documents.

Use single quotes for speech. Use doubles within singles if necessary.

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S

Silent ‘h’ words

Use ‘a’ with words pronounced with a hard ‘h’ - for example ‘a hotel’, 'a hospital'. Use 'an' with words pronounced with a soft/silent ‘h’ - for example ‘an honour’.

Spaces

Use a single space only following a full stop (never a double space). Add spaces around an en dash, but not around an oblique – for example and/or.

Specialisms

Specialisms should have capitals at the start of each word. For example, Occupational Therapy and Plastic Surgery.

When ‘and’ is used in a specialism, this should be written as a word. The symbol ‘&’ should not be used. For example, Ear, Nose and Throat.

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T

Tables

Only use for data values and never to contain large amounts of text. Bulleted lists or Heading / Sub-heading groups are a much better way to represent this information.

Time

Use 1.00am, 6.30pm, rather than the 24-hour clock. Note no space between the time and 'am' and 'pm', and no points. Use a full stop rather than a colon to separate hours and minutes.

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U

Underline

Don’t do it (apart from underlining for links).

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Y

You

Use the second person as much as possible and be consistent.

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A

antibody test

asymptomatic – only use when referring to (community) asymptomatic test sites. If referring to people, use ‘without symptoms’ or ‘do not have symptoms’

B

booster dose – for people with a severely weakened immune system, see third primary dose

C

close contact

community test site – also referred to as community asymptomatic test site

contact tracing – and (NHS Scotland) contact tracer

coronavirus – use coronavirus (COVID-19) for page titles and the first reference on a page then refer to coronavirus only thereafter. Coronavirus is only capitalised at the start of a sentence. Not ‘Covid-19’ or ‘covid-19’. COVID OK in the context of Long COVID and COVID Status

coronavirus outbreak – used in a national context, for example the Scottish Government have published guidance to help households during the coronavirus outbreak

coronavirus pandemic – used in an international context

coronavirus vaccine – the coronavirus (COVID-19) vaccine in the first instance then coronavirus vaccine or vaccine or vaccination thereafter. Not immunisation

coronavirus vaccination/vaccine invitation letter – not invite

D

drive-through test site

drop-in clinic(s) - a place to get the coronavirus vaccine, a type of open access service

E

extended household – not bubble

F

face covering – not face-covering

face mask – medical protective equipment

I

infectious

isolation note – sent to employer. Not a ‘sick line’

L

LFD test – lateral flow device (LFD) test in the first instance then LFD test thereafter

long COVID – COVID always capitalised

M

medical exemptions – people who cannot receive the coronavirus vaccine for medical reasons

mobile testing unit

N

NHS Scotland COVID Status – can be shortened to COVID Status after the first instance

O

open access service(s) – use drop-in clinic(s)

P

PCR test – PCR (polymerase chain reaction) test in the first instance then PCR test thereafter

personal protective equipment (PPE)

physical distancing – not social distancing

protection level – use protection level (tier) or protection levels (tiers) in the first instance and level(s) thereafter. Do not capitalise. Use ‘at’ not ‘in’ when referring to levels, for example ‘At level 0 you can...’

protection measures

Protect Scotland app

Q

QR code – not 2D barcode

quarantine – used in the context of international travel

R

restrictions

S

self-isolate/self-isolation – not isolate/isolation unless referring to household isolation

Self-Isolation Support Grant – capitalised, for example ‘If you are told to self-isolate by Test and Protect you may be eligible for a £500 Self-Isolation Support Grant.’

shielding – use highest risk rather than shielding, but explain these are the same

T

Test and Protect – not Test and Trace

third primary dose – for people with a severely weakened immune system

tier – see protection level

V

variant – new variant, variant of concern or specific variant, for example Delta variant

W

walk-through test centre

we – try to be specific of who ‘we’ is if possible, for example NHS Scotland