Accessible results: co-designing patient-centred blood test result communication in England

Background

In England, NHS policy has expanded patient access to online blood test results to improve efficiency and patient engagement. However, many patients struggle to access and understand their blood test results online, especially those with lower health literacy or digital confidence. If results are not clear and meaningful to patients, online access can increase confusion, anxiety, workload, and inequalities through digital exclusion.

Methods

The ‘Accessible Results’ study uses a person-based, co-production approach to improve online communication of blood test results in primary care. We conducted think-aloud interviews with 39 patients and 19 primary care staff across six GP practices in England, in diverse socioeconomic contexts. The interviews explored experiences of accessing, understanding and communication of test results. Patient-centred communication templates and a GP toolkit to support accessible result communication were developed through co-production workshops (n = 8), involving patients, carers, primary care and laboratory staff, industry stakeholders and community groups. Patient and public involvement was embedded throughout. A web-based vignette study is underway to test whether simplified wording and alternative formats improve understanding, reassurance and intended healthcare use.

Results

Patients valued access but often found results difficult to interpret. Challenges were greater among those with lower health literacy, limited digital access or accessibility needs. Staff reported difficulties providing accessible explanations and concerns about workload and inequalities. Participants emphasised the importance of maintaining non-digital alternatives.

Conclusions

To ensure equitable and useful access, results need to be presented in ways that patients can understand and act on. Co-produced templates and practical support for staff can help to improve patient understanding and extend digital health benefits to more of the population.

Key messages

• Expanding digital access to test results must be matched by accessible communication. Otherwise, health systems risk increasing confusion, anxiety and widening health inequalities.

• Co-production with people most affected by digital exclusion is essential to develop tools that are usable, relevant and support equitable management of care across the digital divide.