Changes to access of the Voltage gated calcium channel antibody assay

Haemophilus antibody (HIB) testing

Welcome to Oxfordshire Wheelchair Service

Botulinum toxin injections for spasticity

Upper Limb Spasticity Clinic

Spasticity

Occupational Therapy at the Oxford Centre for Enablement (OCE)

High-sensitivity troponin

Fatigue Management

Orthotics

Ensure that PDF documents specifies headings for accessibility.

## What this means

Specifying headings in a PDF involves clearly defining tagged heading elements within 
the document. These headings are used to structure the content, similar to how headings 
are used in web content (like HTML). 

## Why it matters

1. **Accessibility**: Headings are crucial for screen readers and other assistive technologies. They allow users with visual impairments to navigate the document more easily.
2. **Document Structure**: Clearly defined headings help in organizing the content, making it more understandable and navigable for all users.
3. **Search Efficiency**: Proper headings improve the document's searchability, enabling users to find information more quickly.

## How to fix

1. **Use Styles in Document Creation**: When creating a document, use heading styles (like Heading 1, Heading 2, etc.) in your word processor before converting it to a PDF.
2. **Edit Existing PDFs**: If your PDF is already created, use a PDF editor to add or modify heading tags. Ensure that the headings are in a logical hierarchical order.

## Testing Methodology

Silktide flags PDFs that don't contain a single tagged heading.

## Further Reading

- [WCAG PDF9](https://www.w3.org/TR/WCAG20-TECHS/pdf.html#PDF9)
- [Creating Accessible PDFs](https://www.adobe.com/accessibility/pdf/pdf-accessibility-overview.html)
- [PDF Accessibility - Defining PDF Accessibility](https://www.webaim.org/techniques/acrobat/)

pdf-missing-headings

February 2026

January 2026

Oxford University Hospitals NHS Foundation Trust

	Title / URL	Issues
	Changes to access of the Voltage gated calcium channel antibody assaywww.ouh.nhs.uk/media/h1ohb1jw/calcium-channel.pdf	1
	Haemophilus antibody (HIB) testingwww.ouh.nhs.uk/media/znufd2tn/hib-testing.pdf	1
	Welcome to Oxfordshire Wheelchair Servicewww.ouh.nhs.uk/media/vesl2rud/104646ows.pdf	1
	Botulinum toxin injections for spasticitywww.ouh.nhs.uk/media/sxqj2d3f/105521botulinum.pdf	1
	Upper Limb Spasticity Clinicwww.ouh.nhs.uk/media/syohqp4t/104071limb.pdf	1
	Spasticitywww.ouh.nhs.uk/media/o30d5mbp/105520spasticity.pdf	1
	Occupational Therapy at the Oxford Centre for Enablement (OCE)www.ouh.nhs.uk/media/yqzptokc/91631oce.pdf	1
	High-sensitivity troponinwww.ouh.nhs.uk/media/w50ilmwy/troponin-pathway.pdf	1
	Fatigue Managementwww.ouh.nhs.uk/media/233onncp/101977fatigue.pdf	1
	Orthoticswww.ouh.nhs.uk/media/zoxd1nhe/110161orthotics.pdf	1

Specify headings for every PDF

Oxford University Hospitals NHS Foundation Trust

Where this issue has occurred