Content guide - Formatting

Formatting and structuring text, including headings, links and lists.

Abbreviations and acronyms

We explain an abbreviation or acronym in full on its first use unless it's well known, like UK, NHS, GP. Then we refer to it by initials.

Example: A body mass index (BMI) above the healthy weight range can increase your risk of serious health problems.

Aligning text

Left-align text in English.

Some people with cognitive differences have difficulty with blocks of text that are justified (aligned to left and right margins).

Also people who use screen magnifiers may miss text that is not left-aligned.

For translations into languages that run right to left (like Arabic), right-align instead.

Find out more about text alignment in the design system.

Bold, italics and underlining

Use bold sparingly. Do not use italics or underlining (except for links, which are underlined by default).

Use bold in technical instructions to tell users which element (for example, a text input or button) to select. For example: Select More, then select Messages.

Do not use bold to emphasise text. To emphasise words or phrases, you can:

• front-load sentences
• use headings
• use bullets
• use words like "important" in your content

Why we say this

Large areas of bold, italics or underlining can be difficult for some people to read. Too much bold makes it difficult for them to know which parts of your content to pay most attention to.

People may mistake stand-alone bold text for a heading and underlined text for a link.

By default, screen readers do not announce text in these HTML tags differently:

• <b> or <strong> for bold
• <i> for italics
• <em> for emphasis

Users may miss anything you wanted to express by using them.

Headings

Headings help users understand what the page covers and find the information they need. Use them to break up and structure text.

Write good headings

Make sure your headings:

• are written in sentence case (see capitalisation on the Punctuation page)
• are clear and concise
• describe the content that follows
• start with keywords, if possible
• are action-oriented, if possible (for example, "View your GP health record")
• are not written as questions (except in forms, for example, "What is your address?")

Main heading or h1

Give your content a unique and informative main heading, which will be heading level 1, or h1. You should only have one h1 per page.

Keep your h1 concise, ideally 65 characters or less, including spaces.

Main headings and page titles

The page title in the HTML metadata (the <title> tag) usually includes the h1 together with the website name, separated by a dash. A simple example is "Flu – NHS", which is the page title for the flu page on the NHS website. It shows in the browser tab.

If you use a content management system (CMS), it may create the title from your h1 automatically.

Find more information about setting up page titles in the Page template, including examples of different text in the h1 and page title.

Structure content with headings

Use heading levels (subheadings, starting with h2 and going down to h4) to break up your content and give it a sensible structure. With each heading, ask yourself if it's a sub-section of the previous heading, the same level or higher.

Make sure that headings follow the correct "nesting" order, without skipping a level.

• h1
•  h2
•   h3
•    h4

Avoid using h5 headings. If you need 5 heading levels, your content is probably too complex.

More information in the service manual

Find out about:

• setting up page titles in HTML, in the page template section of the design system
• using headings correctly, in the accessibility guidance
• styling headings, in the typography section of the design system

Links

Make links active, specific and concise.

Links should describe where they're taking the user. Where you can, use the same words as the title of the page you're linking to. That way, the user will know what to expect.

We do not use link text such as "click here" or anything that does not make sense when read out of context. Screen readers can move between links without reading the surrounding content.

We would use:	We would not use:
symptoms of asthma	symptoms
more about asthma	more information

Avoid using "see", "read" or "view" in link text. Consider using:

• "Find out about ..."
• "Find out more about ..."
• "Learn about ..."

Avoid opening new tabs or windows

Avoid using links or buttons that open new tabs or windows.

There are 2 exceptions to this:

• for instructions or other help with filling in a form (for example, a date picker)
• if a user has logged into a secure site and the link would take them away from it

Read more about opening new tabs or windows only when necessary (on W3C, WCAG2.2).

If links do go to a new tab, warn the user by saying: "Link name (opens in new tab)". Include all of this in the link text.

Avoid linking to PDFs

Wherever possible, we avoid publishing PDFs or linking to them. Read our guidance on PDFs and other non-HTML documents.

We prefer to link to an HTML page containing the PDF. That way, if the PDF is changed or updated, users can still find the latest information.

If we need to link to a PDF, we:

• open it in the same tab
• add "PDF only, [file size in MB or KB]" in brackets to the end of the link text, for example: "weight loss progress chart (PDF only, 545KB)"

Round up values over 1MB to 2 decimal places to keep it as accurate as possible.

Round up values under 1MB to the nearest KB. For example, round up 835.74KB to 836KB.

Lists

Use lists to make text easier to read.​

Bulleted lists should be short and snappy. If possible, limit your list to no more than 6 items.​ Each item in the list should be roughly the same length.

We use bullet points in:

• the pattern to help users decide when and where to get care (care cards)
• Do and Don’t lists

Lists with a lead-in line

This is our preferred list style.

Use a lead-in line with a colon. The bullets should make sense running on from the lead-in line. In effect, the list is 1 continuous sentence.

Each bullet point starts lower case and has no punctuation at the end, including after the last point.

Do not include more than 1 sentence at each bullet point.

Do not use a heading for a lead-in line.

Avoid ending a bullet point with "and" and "or". Use the lead-in to let people know the options.

Full sentence lists

If your user research shows that it helps your users, you can use full sentence bullet points. For example, our medicines information uses full sentence bullet points for key facts.

Each bullet point should be distinct information, start with a capital letter and end with a full stop. There should be no lead in line.

Numbered lists

We use numbered lists instead of bulleted ones to guide people through a process. Each point starts with a capital letter and ends with a full stop, without a lead-in line.

Help us improve this guidance

Share insights or feedback and take part in the discussion. We use GitHub as a collaboration space. All the information on it is open to the public.

Read more about how to feedback or share insights.

If you have any questions, get in touch with the service manual team.

Updated: February 2025