Content and legibility of outpatient appointment letters

To assess whether outpatient appointment letters can be read by visually impaired people and to examine the information they contain.

Postal survey of hospital outpatient departments in England and Wales.

Royal National Institute for the Blind (RNIB) guidelines for print size and weight, colour contrast between paper and print and use of capital letters; checklist of items of information contained.

We asked 295 hospital trusts for copies of their outpatient appointment letters, and received 158 samples. In 87% the print size was too small to be read by visually impaired people. All used contrasting paper and print colour, but 13% used too light a print weight. Twelve percent used capital letters throughout which are harder to read than lower case lettering. Information content was variable. Twenty letters specifically designed for low vision clinics were assessed separately; all used adequate print size and weight, but 55% used capitals throughout.

Most outpatient appointment letters are not easily read by visually impaired people. Important items of information are omitted from some letters.