Style and punctuation

A guide on style and punctuation on NHS inform

Use this page to search for guidance on style and punctuation. You can use the alphabet below to jump to the relevant letter.




Do not put a full stop a the end of:

  • Dr
  • Mrs
  • Mr


You should spell out an acronym in full the first time it’s used. Put the acronym in brackets immediately after. For example, abdominal aortic aneurysm (AAA).

You should then use the acronym throughout the rest of the page.

Do not use full stops in acronyms. For example, AAA, not A.A.A.

You can use an acronym to replace a name or term that appears often in a page. But, don’t include an acronym unless you’ll use it several times later on in the same text.

You do not need to spell out common acronyms. This includes government departments and schemes. For example:

  • DVLA
  • EU
  • HMRC
  • MSP
  • UK
  • USA
  • VAT


The ampersand (&) symbol should only appear in:

  • the logo image of an organisation or department
  • a page title

Always use ‘and’ in headers, sub-headers and body copy.


Apostrophes should be used on plural words. For example, ‘Choices’ style guide’ and not ‘Choices’s style guide’.

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Use bold sparingly.

Bulleted lists


  • use a lead-in line that ends with a colon
  • make sure all bullet points make sense following on from the lead-in line
  • use lower case at the start of the bullet point
  • put bullet points in the same tense and verb form, with any common information in the lead-in
  • add links within the text and not as the whole bullet point
  • make sure lists are consistently phrases or sentences – don’t combine style in one list
  • try to avoid using complete sentences – if you need to use complete sentences, start with a capital letter and end with a full stop for each line


  • do not put a full stop after the last bullet point
  • do not put ‘and’ or ‘or’ after any bullet point, although there may occasionally be a need
  • do not use full stops within bullet points – where possible start another bullet point, or use commas or dashes to expand on an item

You can use numbered steps instead of bullet points to guide a user through a sequential process. Each step ends with a full stop because each step should be a complete sentence.

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Capital letters

You should use capital letters for organisations, projects or initiatives. For example, the National Gallery or National Care Standards. You should not use capitalisation for an organisation if they do not do it themselves.

You should not use capitals in words like ‘a’, ‘an’, ‘and’, ‘at’, ‘for’, ‘from’, ‘in, ‘of’, ‘to’ and ‘the’.

You should use capital letters when writing about a specific act. For example, Patient Rights (Scotland) Act 2011.

Use lower case for ‘act’ on its own and for legal concepts like ‘power of attorney’.

You should capitalise the name of the website in the same way they do. You should do this even if this is different to our capitalisation rules.


Use a colon to introduce a list of bullet points.

Never use semicolons.


Only use a comma for complex sentences or to prevent confusion.

This is an example of a complex sentence:

‘Eating a healthy diet that includes lots of fruit, vegetables, whole grains and a moderate amount of unsaturated fats, meat and dairy can help you maintain a steady weight.’

This is an example of when you could use a comma to make a sentence simpler:

‘Eat lots of fruit, vegetables, whole grains and some unsaturated fats, meat and dairy. This will help you keep a healthy diet.’

Contact information

You should be consistent when giving contact information like a phone number. Contact information should be in this style:

Phone 0300 000 040, Monday to Friday, 9am to 5pm.


Contractions are made by shortening and combining two words. For example, don’t (do and not) and won’t (will not).

You should use contractions consistently.

There are some instances where contractions aren’t suitable. You should use your common sense when deciding if they are appropriate are not.

Do not use ‘who’re’ or ‘isn’t’.

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You can use a dash instead of a colon to introduce a call to action or list. But, use a bulleted list if this would make the information clearer.

A dash is less formal and can help the flow of content.

Do not use em dashes (—).

En dash

The en dash (–) is slightly wider than the hyphen (-) but narrower than the em dash (—)

You can use an en dash to add more information to a sentence instead of parentheses or commas.

Always put a space before and after an en dash.

Example of dashes

You can fill in the form – paper or online version – to tell us about a change.

It’s important to tell us about any changes immediately – so act now.


You should write a date as:

23 January 2023

Don’t include ‘the’, or a ‘th’ after the day.

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Exclamation marks

Exclamation marks are almost always unnecessary. If you absolutely have to use an exclamation mark, never use more than one.

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Fractions and percentages

Spell out common fractions like two-thirds.

Use % for percentages like 20%.

It’s often best to avoid using percentages. For example, you could say ‘1 in 2’ or ‘half’ instead of 50%.

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Health boards

Use ‘local health board’ lowercase unless referring to a specific board.

Specific health boards should have capitals at the start of each word. For example, NHS Western Isles.

When ‘and’ is used in a health board, this should be written as a word. The symbol ‘&’ should not be used. For example, NHS Greater Glasgow and Clyde.


As English evolves, compound adjectives often become single words. For example, bloodstained, overblown or underdone. This is also true of compound nouns. For example, steam ship became steam-ship, then steamship. In general, favour the hyphenless form of a word.

A phrasal adjective is a phrase that modifies a noun. You should use hyphens for phrasal adjectives that come before the object. For example, ‘quality-assured website’ instead of ‘this website is quality assured’.

When not to use hyphens


  • do not use hyphens for adjectives after the noun – for example, ‘the boy was 14 years old’ or ‘the gap was 5 miles wide’
  • do not use hyphens between an adverb and a participle – for example, ‘poorly written prose’ or ‘highly charged drama’
  • do not clash letters when using hyphens – for example ‘blue-eyed’
  • do not hyphenate words with ‘re’, except to avoid a clashing e (re-elect), or to avoid a visual problem (re-ignited) or to distinguish 2 meanings (re-form)

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Do not use italics.

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Medical spellings

Conditions are spelled in lower case, except for the likes of Alzheimer’s disease.

Abbreviated conditions or those with acronyms should not have full stops after the letters. For example, AIDS and HIV.

Avoid medical jargon and technical terms as far as possible. If you must use them, explain them.

Put the common terms first, for example ‘flu (influenza)’ rather than ‘influenza (flu)’.


Use the British National Formulary to check the spelling of a medicine. You will have to register online, but it’s free and is updated monthly.

When writing the name of a medicine, use the generic (scientific name) followed by the brand name in brackets with a capital letter. For example, ‘atorvastatin (Lipitor)’.

Use lower case to describe a generic medicine and upper case for a brand name.

There may be several brand names for a medicine. In this case, you should give the most well-known brand name but explain there are several. For example, ‘salbutamol (brand names include Ventolin)’.

Some medicines have no brand names in use. This includes warfarin and hydrocortisone.

Some medicines are best known by their brand name like Viagra. In this case, you should give the generic term in brackets. For example ‘Viagra (sildenafil)’.

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Write all numbers in numerals, except where it’s part of a common expression and it would look strange. For example, ‘one or two of them’.

Other rules for writing numbers include:

  • 1,000, 2,000
  • 500 to 600 (use ‘to’ instead of a dash)
  • spell out first to ninth when writing ordinal numbers and after that use 10th
  • use numerals throughout tables

Don’t begin a sentence with a number that is not written out unless that number is a date.

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Use the singular form of a verb for organisations. For example, ‘CIS is a service…’ and not ‘CIS are a service…’

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  • break text up with many paragraphs
  • keep paragraphs short – aim for no more than 3 sentences
  • aim to communicate just one idea per paragraph
  • remember you can have a one sentence or one line paragraph
  • remember that paragraphs don’t need to be for a new subject matter


Parentheses is added to a sentence to provide an explanation or extra information. It’s separated from the main part of the sentence. You should use parentheses sparingly.

Dashes are better than parentheses for web content, but you should only use it for one aspect of a sentence.

PDFs and other documents

You should include the document size when adding it to content. For example:

  • (PDF 358.7 KB)
  • (DOC 1.7 MB)
  • (ZIP, 40 MB)

Only quote up to 1 decimal place and always open documents in a new window.

File sizes should have a space between the number and the measure. Measures should always be in capitals. For example, KB instead of kB.

Phone numbers

Use the word ‘phone’ and not ‘call’ or ‘telephone’.

Write the number in one of these formats:

  • 01273 800 900
  • 020 7450 4000
  • 0800 890 567
  • 07771 900 900
  • 077718 300 300
  • +44 (0)20 7450 4000
  • +39 1 33 45 70 90

Follow the organisation’s style for its number if it’s different from these examples.

Positive form

Replace a negative form with a positive one wherever possible. For example, replace:

  • ‘not able’ with ‘unable’
  • ‘not available’ with ‘unavailable’
  • ‘not forget’ with ‘remember’
  • ‘not omit’ with ‘include’
  • ‘not pay attention to’ with ‘ignore’
  • ‘not possible’ or ‘unfeasible’ with ‘impossible’
  • ‘not sure’ with ‘unsure’

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Quotation marks


  • use single quotation marks for unusual terms that need explanation
  • use quotation marks sparingly
  • use single quotes for speech
  • use double quotes within singles if necessary


  • do not use quotation marks for titles of publications or documents

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Silent ‘h’ words

Use ‘a’ for words pronounced with a hard ‘h’. For example, ‘a hotel’ or ‘a hospital’.

Use ‘an’ for words pronounced with a soft or silent ‘h’. For example, ‘an honour’.


Only use a single space after a full stop (never a double space).

Add spaces around an en dash, but not around an oblique – for example and/or.


Specialisms should have capitals at the start of each word. For example, Occupational Therapy and Plastic Surgery.

When ‘and’ is used in a specialism, this should be written as a word. The symbol ‘&’ should not be used. For example, ‘Ear, Nose and Throat’.

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Only use tables for data values and never to contain large amounts of text. Bulleted lists, headings or sub-headings are a better way to present this information.


Use 1.00am or 6.30pm, rather than the 24-hour clock. There should be no space between the time and ‘am’ and ‘pm’.

Use a full stop rather than a colon to separate hours and minutes.

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Do not underline any text, unless it is the underline on a link.

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Use the second person as much as possible and be consistent.

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