The Readability of GP Surgery Websites

Problem

Most GP surgeries in the UK have a website which they commission and update themselves. There is an impetus from government to increase the provision of services that GPs offer online, such as appointment booking and the ability to order repeat prescriptions. The current websites’ text and design are of variable quality. This matters because adult literacy levels are low. Similar to elsewhere in the UK, 1 in 4 Scottish adults experience serious challenges due to poor literacy, and those from the 15% most deprived communities are twice as likely as those in the most affluent group to only reach the lowest literacy level. Despite the rising role of GP websites as a source of information and point of interaction, to our knowledge there has been no published research into how understandable GP websites are to their lay audience, or whether practices adapt the readability of their websites to cater for their populations, knowing that affluent areas tend to have higher literacy levels than deprived areas.

Approach

Both word choice and webpage design dictate the ease with which online text may be scanned or read. Using a standardised text-difficulty score, we analysed the five most visited webpages of each of the 941 GP surgeries in Scotland. We developed a design score drawing on literature about design factors that facilitate readability and accessibility. We then scored the ‘appointments’ webpage of each surgery website. We assessed for any correlation between the text-difficulty score for surgery’s website, and the Scottish Index of Multiple Deprivation (SIMD) group to which the surgery’s population belonged.

Findings

85% of practices in Scotland had a website, and 77% (2949/3822) of the webpages had a ‘reading age’ above that of the average UK adult. The majority were also above the recommended reading level for public websites. There was a spread in design scores despite 51% of the websites sharing a small number of design templates from a single website provider (‘MySurgeryWebsite’). There was no association between webpage ‘reading age’ and the measure of a practice population’s level of multiple deprivation (SIMD), suggesting that practices do not adjust their websites to suit the potential average literacy levels of their populations.

Consequences

This is a novel and timely piece of work as it is the first time that the area has been studied in this depth and comes at a time that government is encouraging GPs to conduct more interaction with their patients online. It highlights that most surgery websites are too complex for much of the population to fully understand, and design factors that facilitate accessibility and readability are not widely followed. We have identified simple changes that can be made by GP surgeries to improve the accessibility of their online provision.