Arabic.pdf

a9ddcad3-e2d9-468f-8b23-e2da852180b8

Patient Experience Annual Report 2023 2024_ 003.pdf

Chinese.pdf

Somali.pdf

bdce0e74-7497-4b57-9991-0e86c90c04f1

6a568abe-303d-418a-b865-88a81a217b4f

a8fccce3-69ad-4d14-a089-94c2c12c8439

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

January 2026

December 2025

The Royal Orthopaedic Hospital NHS Foundation Trust

Title / URL	Issues
Arabic.pdfroh.nhs.uk/images/Arabic.pdf	1
a9ddcad3-e2d9-468f-8b23-e2da852180b8roh.nhs.uk/images/Easy%20Read%20Strategy.pdf	1
Patient Experience Annual Report 2023 2024_ 003.pdfroh.nhs.uk/images/Patient%20Experience%20Annual%20Report%202023%202024_%20003.pdf	1
Chinese.pdfroh.nhs.uk/images/Chinese.pdf	1
Somali.pdfroh.nhs.uk/images/Somali.pdf	1
bdce0e74-7497-4b57-9991-0e86c90c04f1roh.nhs.uk/images/Patient%20experience%20report%20summary.pdf	1
6a568abe-303d-418a-b865-88a81a217b4froh.nhs.uk/images/POAP%202025.pdf	1
6a568abe-303d-418a-b865-88a81a217b4froh.nhs.uk/images/ROH%20Trust%20Strategy%20Refresh%20Document.pdf	1
a8fccce3-69ad-4d14-a089-94c2c12c8439roh.nhs.uk/doc-men-hidden/hospital-map/373-hospital-site-map/file	1
bdce0e74-7497-4b57-9991-0e86c90c04f1roh.nhs.uk/images/ROH%20Strategy%202023-2028.pdf	1

Specify headings for every PDF

The Royal Orthopaedic Hospital NHS Foundation Trust

Where this issue has occurred