Imagery: photography and illustrations

Photography and illustrations are powerful and emotive tools that express our values just as strongly as colours and typefaces.

The NHS is not only about making people well. It’s also about keeping them healthy and helping them to make informed choices about their health. And the images that we use in our communications need to reflect this.

When selecting images for use in NHS communications, think about whether they:

  • tell people that we value professionalism, equality and accessibility;
  • enhance the reputation of the NHS and reflect the pride we have in our work;
  • adhere to our communications principles.

Using pictures

Images and graphics are widely used in the NHS. For example:

  • murals on a children’s ward;
  • photographs in an annual report;
  • illustrations on a website;
  • diagrams in a patient leaflet.

All of these images communicate in different ways, and all will say something about our identity and our values.

Images in support of our principles

Images and illustrations can enhance our publications if they follow and express our principles. It’s difficult to give hard and fast rules about such a varied subject, but the following points and examples give some guidance.


Our core purpose is health

  • Good example: pictures that support, or don’t contradict, our messages about healthy lifestyles.
  • Bad example: people enjoying smoking, or taking risks that might lead to accidents.

Comment: not every picture actually has to promote health, but avoid those that contradict our core purpose.


We are a people organisation

  • Good example: pictures of real people – staff, patients, the public.
  • Bad example: endless pictures of buildings or equipment.

Comment: obviously, not every picture has to be of a person, but if it’s a straight choice between a building and a person, choose the person.


We respect people

  • Good example: pictures that show we care and understand.
  • Bad example: a ‘funny’ cartoon of a patient suffering from stress; a drawing of an elderly person that reinforces a stereotype; a modern art mural that might shock or offend.

Comment: this is sometimes a difficult principle to judge. Use your instinct – if it makes you feel uncomfortable, it’s probably wrong. Using humour in a healthcare environment can appear disrespectful. Only use humour if you can do so in a way that shows professionalism, respect and care.


We must be straightforward, accessible and clear

  • Good example: clear diagrams, sharp pictures, well-drawn maps.
  • Bad example: tiny photos, diagrams that have been photocopied so many times they are unreadable.

Comment: this applies mostly to images that are intended to give information. With drawings, use well-drawn pictures that are easy to understand. They can be modern or stylized so long as they are professional and clear.


We serve a diverse population, in a range of settings

  • Good example: pictures of young and old, men and women, people from different ethnic backgrounds, in hospitals, homes, ambulances, GP clinics.
  • Bad example: a photo selection where every face is young and white.

Comment: not every image can show every range – but think about the overall message that your picture selection is giving.


We must be effective

  • Good example: a drawing that shows clearly what a leaflet is about.
  • Bad examples: a design behind text that makes the print difficult to read.

Comment: think about the purpose of the picture and make sure it does its job well.

These guidelines

These guidelines should help you think about images, but they cannot cover every decision you have to make. You need to use your judgment and discretion. In particular, avoid clipart or any other prefabricated images from the internet. These suggest a lack of effort and imagination, and can risk looking like a crude ‘cut and paste’, rather than careful selection. The quality of such images, like that of other illustrations, can also be hard to control.

In general, photography offers a stronger and more accurate representation of real life. In most environments, photography is preferable to cartoons and illustrations. When searching for photography, make use of the NHS Photo Library,, which contains a vast range of relevant and sensitive images.

Last updated: 19/05/08