Step by Step Writing
Guide for Developing
Plain English
Consumer Information
Contents
What is plain English and why use it? ..................................................................................... 3 Plain English – before and after .............................................................................................. 4 Step 1: The Planning Stage .................................................................................................... 5 Step 2: Writing your Consumer Resource .............................................................................. 6 Step 3: Design and Layout...................................................................................................... 7 Step 4: Checking and testing your resource ........................................................................... 8 Step 5: Getting your Resource Approved and Published ....................................................... 9 Checklist for Developing Posters ............................................................................................ 9 Consistent Features .............................................................................................................. 11 Words and Phrases to Avoid ................................................................................................ 12 Everyday words ............................................................................................................. 12 Concise words ............................................................................................................... 14 Medical Terms ............................................................................................................... 15 Revision 5
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What is plain English and why use it?
Plain English is a style of presenting information that helps consumers understand
health information the first time they read or hear it. It is a more efficient way of
writing. This guide will help you to produce plain English resources for your patients,
clients and carers. To write in plain English you need to first put yourself in your
reader’s shoes. When you use plain English you:
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write in clear language,
give relevant information in the right order, and
help consumers to find this information quickly.
By providing plain English health information, we can help to make sure that
consumers:
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arrive on time for their appointments
properly prepare for procedures or operations;
remember what their health care provider has told them. (Many consumers,
due to stress or language difficulties are unable to remember medical
information and/or instructions) ;
make informed decisions with confidence, giving them time to go away, read
the information that is relevant to them, and think about the issues involved;
are involved in decisions about their condition and their treatment; and
have an overall positive experience of the ISLHD.
In this document, you will find checklists to guide you step-by-step through the
planning, writing, design and layout through to the testing and final review of your
consumer information resource. We recommend you work through each stage of the
checklist as this way you will produce a high quality patient resource which is in plain
English and which meets the needs of your consumers.
A printing guide is also available to guide you through the steps of getting your
resource ready for printing. Click here to access the ‘Step-by-Step Printing Guide for
Plain English Consumer Information’ or find the guide in the Patient Information
Portal (PIP) tool kit page.
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Plain English – before and after
Using plain English can make a big difference; have a look at these ‘before’ and
‘after’ examples which have been reviewed using a readability formula to calculate
how difficult the information is to read. Use this readability formula as a broad guide,
but remember it can only check the difficulty of the language, not the content.
Before
Mammography Patient Information
Women in the three high risk categories-age 50 or more, age 40 or more with
a family history of breast cancer, age 35 or more with a personal history of
breast cancer- may consider an additional routine screening
method….Mammography uses radiation (x-rays) to create an image of the
breast…It can reveal tumors too small to be felt by palpation….
Readability Consensus
Based on 8 readability formulas, we have scored your text:
Grade Level: 14
Reading Level: difficult to read.
Reader's Age: 21-22 yrs. old (college level)
After
What is a mammogram and why should I have one?
A mammogram is an x-ray picture of the breast. It can find breast cancer that
is too small for you, your doctor, or nurse to feel.
Studies show that if you are in your forties or older, having a mammogram
every 1-2 years could save your life.
Readability Consensus
Based on 8 readability formulas, we have scored your text:
Grade Level: 6
Reading Level: easy to read.
Reader's Age: 10-11 yrs. olds (Fifth and Sixth graders)
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Now it’s time to start producing your consumer information resource. You can
contact the Health Literacy Ambassador in your service / ward, or the Patient
Information Team in the Clinical Governance Unit if you need assistance.
Step 1: The Planning Stage
Planning Checklist
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Work out who will coordinate the development of the consumer information
resource in your service or ward, for example, an identified individual, or
perhaps an established committee will be taking the lead.
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Identify the need for specific information from consumers, carers and
clinicians and other health staff as appropriate.
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Don’t reinvent the wheel - check what other relevant information already
exists in your service or in the organisation by checking on the ISLHD
Register of Consumer Information, or from other outside sources such as
the Multicultural Health Communication Service or non-government health
organisations, such as the Heart Foundation or Diabetes Australia.
Consider how the resource will be distributed. Will it be available on a
display rack, handed, posted or e-mailed to the consumer? Also, which
service / team / ward, etc takes responsibility for this?
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Identify funding (if needed, for example for printing) –it may be more costeffective to arrange for printing of your resource rather than photocopying,
and the quality is better. This printing guide will help you through this
process
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Step 2: Writing your Consumer Resource
Plain English
Principle
√
Guidelines
1. Keep your
sentences short:
 An average sentence should contain no more than 15 to
20 words.
2.Use everyday
words
 Use words the reader will understand – this does not
mean use simple words. Try to avoid acronyms or jargon.
 When using acronyms, such as CEC(Clinical Excellence
Commission) spell them out the first time you use them
 Present your information in a logical order
3.Be personal use “you and
“we”
 Use “you” and “we” to keep sentences short, clear and
personal
4. Be consistent
4.Be positive
For example: “you must send us” and “your appointment is
on…’, and ‘please bring with you…’
 Be consistent with terms or words. For example, if you
use the word ‘test’ use this term throughout your
document - it can be confusing if you use the word ‘check’
or ‘evaluate’ for the same thing.
 For example, “Give yourself plenty of time to get to the
bathroom safely - rushing may cause you to fall’
5.Use the active
voice
 The active voice is more personal and direct and makes it
clear who’s doing what. For example: ‘We will send the
results to you…’ rather than ‘the results will be sent …..’
6. Avoid
nominalisation
 Nominalisation refers to the use of verbs or adjectives as
a noun. Say:
 ‘complete instead of ‘the completion of’
 ‘arrange' instead of ‘the arrangement of’
 ‘provide’ instead of ‘the provision of’
7.Use
lists/questions
 This is a good way to break up long sentences, for
example:
‘This is what do you need to bring to your next visit:
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Your Medicare card
Your birthing plan, etc
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8. Give direct
instructions
“Tell your nurse if you have had gestational diabetes (high
blood sugar) with another pregnancy”, or “our service is
located….enter via Crown Street and take the lift to….”
9. Consider the
diversity of your
consumers
 Translations - it may be appropriate to make your
resource available in different languages - contact the
Health Care Interpreter Service for assistance / guidance,
or click here to find out more about translating health
information.
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 When providing contact details, make sure you give
consumers appropriate options, eg: Interpreter Service
number, SMS or email for Deaf patients.
Step 3: Design and Layout
Plain English
Principle
√
Guidelines
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1. White paper
is best
 White paper makes information easier to read
2. Use the right
size font and
casing
 Use at least 12-point font size, Arial or Times New Roman
- any smaller than this and the text becomes difficult to
read.
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 Lowercase letters are easier to read, although uppercase
is always required for the first letters of names and
sentences.
3. Use bold or
larger print to
emphasize
 Do not use all capital letters (upper case), italics,
underlining or red to make points stand out. AS YOU CAN
SEE FROM THIS EXAMPLE, THEY CAN BE DIFFICULT
TO READ AND MAKE IT SEEM LIKE YOU ARE
SHOUTING AT THE CONSUMER. Use bold type or
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a
bigger size to make important points stand out.
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4. Divide and
‘chunk’ your text
 Question and answer format will help you to divide your
text.
 Bulleted or numbered points will help you to break down
complicated information, and will help consumers to
digest it.
 Small blocks of text using headings and paragraph breaks
help to divide your information up.
5. Use numbers
correctly
 Use numbers as words from one to nine because they are
easier to read as words. From 10 onwards however,
represent these as numbers.
6. Use images
carefully
 Diagrams and pictures can be very effective for illustrating
and enhancing text.
 Clearly label all individual pictures and diagrams, but
avoid printing over them.
 Avoid using clip-art, as this can detract from a
professional image.
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Contact ISLHD Communications Department for assistance
with sourcing and using images.
7. Use ISLHD
standard
templates
 Standard ISLHD templates for all patient information
resources are available in both Word and Publisher
formats – you will find all the templates in the Tool box. 
Step 4: Checking and testing your resource
Plain English
Principle
Test your
document
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√
Guidelines
 Testing your resource will help you to check that people
will understand it quickly and easily. The best way to do
this is to:
 ask your colleagues or team to review the resource Give a final draft to everyone who is interested and set
a short deadline for them to respond; and
 test the resource with some of the people who are
likely to use it – use this Consumer Information
Feedback Tool to guide you through this process and
this Consumer Information Feedback Log to record
the feedback you receive.
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Step 5: Getting your Resource Approved and Published
Plain English
Principle
Follow the
correct process
√
Guidelines
 Once you have made any final changes after receiving
feedback from testing your resource you will need to
follow the steps for approval and publishing which are
outlined in the ISLHD Procedure for the Development,
Approval and Publishing of Consumer Information.
Follow the steps outlined in the Flowchart at the back
of the Procedure document.
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Checklist for Developing Posters
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Title Fonts
 Is the title banner readable from 2 metres away?
  Is the font simple and easy to read?
  Is the title in bold and all caps?
  Have you used plain text, with no bold or mixed upper/lower case?   Is the body of the poster readable from about 2metres away (about 96
point size – or 48 points enlarged 200%)?  Are the Dept /authors names printed smaller? Acknowledgment of
partners can be smaller, at about 36 – 48 points)   Use of Colour
 Have you used muted colours, or shades of grey - these are best for the
background. Use more intense colours as borders or for emphasis, but be
conservative – overuse of colour is distracting
  Have you limited the colours to two to three? (including the background)
  Have you used a light background with darker photos and vice versa?
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  Have you used a neutral background (grey) to emphasize colour in
photos?
 (white can reduce the impact of coloured photos)
Sequencing content - The poster should use images, figures and tables
to tell a story
 Is the information presented in a logical sequence?
 Has the information been organised into sections (eg: Situation, Action,
Outcome and Evaluation)?
    Check that the poster does not rely on your verbal explanation to link
together the various sections
Edit Ruthlessly – check that:
 There is not too much text in the poster
  The sentences are short   The layout is around 20% text, 40% graphics and 40% empty
  You have used the active voice when writing the text – ‘It can be seen’
becomes ‘the data shows’
  All redundant references and filler phrases such as see Figure are deleted
  All graphs and figures have explanatory captions (and therefore no need
to label the graphic with figure 1 etc)
  you have avoided using jargon, acronyms etc
 Illustrations
 the images are self-explanatory
  A minimal amount of text is used to support and reinforce the images
  That areas of empty space are used between the sections of the poster to
differentiate between these sections
  Images are visible easily from a minimum of 2 metres away
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Consistent Features
There are certain design features that must be applied consistently and correctly
across all ISLHD materials. The Patient Information Coordinator will make sure the
following features are applied after you have tested your resource and it is ready for
publishing:
Front cover
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ISLHD logo – will be placed on your document once it has been checked and
approved by the Patient Information Coordinator.
Resource title – for example: ‘Warfarin and Surgery’.
Department or facility name where appropriate – for example, ‘Endoscopy
Unit, Women’s Health’.
Back cover
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Contact details (phone, email, address, website address, etc).
PIP website address
PIP Logo
Date of publication
Resource code (Clinical Governance Unit will assign a tracking number to
each plain English consumer information resource).
ISLHD copyright note (will be inserted by the Clinical Governance Unit where
appropriate)
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Words and Phrases to Avoid
We have included some common complicated words and phrases and suggested
alternatives.
Use everyday words as much as possible, this is not ‘dumbing down’, adults prefer
easy to use and easy to read information, especially in health situations which can
often be stressful and rushed.
Everyday words
Instead of:
Consider:
accompany
join
alternatively
or
ascertain
find out
audit
review
avail of
take up, take
benchmark
standard
beneficial
helpful, useful
bi-annually
twice a year
calculate
work out
cease
end, finish
commence
start, begin
confiscate
take from
consequently
so
constitute
make up, form
demonstrate
show
determine
check
disseminate
share, spread
endeavour
try
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eventuality
situation
facilitate
make easier, help, enable
Fundamental
basic
herewith
with
in lieu of
instead of
incremental
gradual, little by little
inter alia
among other things
interim
temporary, meantime
irrespective
regardless
locality
place
modification
change, alteration
operational
working
optimum
best, greatest, most
participate
take part
particulars
details
persons
people
quarterly
every three months
resident,
residing living
terminate
end, finish
utilise
use
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Concise words
Instead of:
Consider:
adequate
number of enough
adjacent to
beside
as a result of
because
at the present time
now, currently
by means of
by, with
come to the conclusion
conclude
draw to your attention
point out, show
during such time
while
excessive number of
too many
for the duration of
during, until the end
for the purpose of
to
give an indication
indicate, signal
give consideration to
consider, think about
hold discussions, meetings
discuss, meet
in conjunction with
with
in possession of
have, own
in proximity to
near, close to
in receipt of
receiving, getting
in reference to
about
in respect of
about, for
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Medical Terms
Instead of:
Consider:
acute
sudden and severe
administer
give
antenatal
before birth
anterior
front
audiology
hearing
benign
harmless
biopsy
studying tissue to check for disease
cardiology
studying and treating the heart
catheter
tube
central nervous system
brain and spinal cord
chemotherapy
treating cancer with drugs
chronic
long-lasting, slow to change
coagulate, coagulation
clot, clotting
congenital
from birth
contagious
spreading easily
contraindication
reason not to take
contusion
bruise
diagnosis
identifying a health condition
dosage
how to take
elective
optional
epidermis
skin
excise
cut out
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gastroenteritis
stomach illness
haemophilia
severe bleeding
hypertension
high blood pressure
immunise
protect
incision
cut
inhalation
breathing in
intravenous
through a vein
lateral
at (on) the side
malignant
harmful, cancerous
mammogram
breast x-ray
medication
tablets, injections (specify)
monitor
keep track of
myopia
short-sight
negative (test results)
you do not have, you are not
normal range
as it should be
oesophagus
gut
ophthalmic
eye
physician
doctor
positive (test results)
you have, you are
post-operative
after the operation
prognosis
likely outcome, chance of recovery
renal
kidney
respiration
breathing
rheumatology
muscles and joints
symptoms
signs of a sickness
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therapy
treatment
trachea
wind pipe
ventricle
lower chamber of the heart
(Source: National Adult Literacy Agency (NALA), Stanford Lodge, Stanford Close, Ranelagh,
Dublin 6 IBSN 078-1-907171-12-3, 2011)
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