Updated: Jul 16, 2020
CN: medical services, booking interpreters, 999, 111, NHS
This week is Deaf Awareness Week 2020 – this week I am doing a series of blog posts, each day of the week.
If you missed the previous two, here are the links:
As contradictory as it sounds, accessing medical services as a Deaf or hard of hearing person is a challenge, from being given phone appointments to refused interpreters or the support you need. So, here is the law and the information you need to have a successful (in theory) appointment or medical experience!
The Accessible Information Standard
In the UK, if you have a sensory loss or disability you are entitled by law to accessible information about your healthcare and support from the NHS and publicly funded social care services. This includes having information provided in an alternative format and having access to an interpreter at your medical appointments.
What must services do to be compliant with the law?
- Find out and record how you need information provided
- Highlight any access needs (such as only being contacted by email) in your medical records to ensure that all staff carry this out
- Share your access needs to other services/hospitals when referrals are made
- Ensure you are given the support you require, including with varying needs
- Regularly ask if your needs have changed
What do I need to do?
- If you realise that you have an access need and have not yet told a member of medical staff, let someone know.
You can do this in various ways such as phone, email, in a letter or in person; there is no formal regulation on what you need to say, but you need to include what your access information is and you might be asked your NHS number and to verify your identity.
- If a medical professional is not meeting your needs (e.g. refusing an interpreter), ask to make a formal complaint.
- Explain that it is your right to have your needs addressed and by law, they must be compliant with this; section 250 of the Health and Social Care Act 2012 [link].
How to contact a member of the team or receptionist of a department
Most NHS hospital departments now have a textphone number - and if you don't have a textphone, often this can be used with Relay UK [link]. Check the appointment letter or the website to check if they have one (if they do not, often it is the same number just with 18001 in front of it).
Alternatively, there is usually an email; however, this is sometimes difficult to find. First, try looking through the relevant web page. You could also ask when at the hospital to have a contact email. If you cannot find one, contact your local deaf charity/organisation, as they may be able to find one or even contact the department for you!
How to book an interpreter
It is worth finding out if the hospital or GP practice has a contract with a certain interpreter provider, such as Remark.
If you have been given a follow-up appointment at the hospital, on the way out you can tell the receptionist that you need an interpreter (such as BSL, lipspeaker or speech-to-text reporter), and they will do the rest for you.
If you get the letter through the post or want to have the interpreter booked in another way, you can use the relay app or ask someone on your behalf to phone the department, and say that you need to book an interpreter for your appointment. Generally, it is asked that you do this at least 2-3 weeks before your appointment is due.
If you have a specific interpreter you wish to book, you can contact them directly through The National Registers of Communication Professionals working with Deaf and Deafblind People/NRCPD [link]– or, if you are based in Scotland, the Scottish Association of Sign Language Interpreters/SASLI [link].
Always make sure the interpreter is registered with NRCPD or SASLI. This way you will know that they have the right qualifications, a DBS check, and that they have the legal obligation to follow a strict code of conduct; as well as being accountable to a complaints procedure should something go wrong.
You will need to provide:
The time and date of the appointment
What type of interpreter you need (e.g. BSL, lipspeaker, speech-to-text reporter)
Do I need to pay?
Under the Equality Act 2010 (the Disability Discrimination Act in Northern Ireland), private, public and voluntary sectors need to make ‘reasonable adjustments’ so that disabled people aren’t placed at a “substantial disadvantage”. These adjustments include providing equipment and communication support, such as an interpreter.
National guidance and quality standards aim to improve the accessibility of NHS and
social care services for people who are Deaf or hard of hearing.
Any communication support needed should be provided, and paid for, by these services. This means they need to be provided and that they are required to pay the interpreter’s charge.
During the appointment
When you arrive, make sure you have informed the reception staff that you are Deaf or hard of hearing if you are struggling to communicate with them, and that you have an interpreter booked.
They will find the interpreter for you and if you haven’t used an interpreter before, the interpreter will explain their role, ask what form of interpretation you want (e.g. some lipspeakers use a mixture of sign too) and you can ask any questions or instruction that you have (e.g. “please can you let me know when they have called me in?”).
I advise arriving at least 15 minutes early to get to know your interpreter a bit first, especially if you have not used them before.
At the start of the appointment, introduce your interpreter to the doctor and explain anything that they might need to knows, such as to talk as normal or that the interpreter will be sitting next to them.
Top tip: When I have an appointment, I usually also have someone with me to take notes or ask my doctor to provide me with a follow-up letter with a summary of what was discussed and any decisions that were made.
After the appointment, I suggest reviewing with them how you thought it went and if you found it useful. If you liked the interpreter, it might be worth getting their name/contact details so you can request them again!
Update: since the COVID-19 pandemic, the Association for Sign Language Interpreters (ASLI), Royal Association of the Deaf (RAD), SignHealth and British Society for Mental Health and Deafness (BSMHD) have produced two guidelines for healthcare professionals on how to adapt to the pandemic while ensuring Deaf people are given support during appointments. There are two documents for communication professionals [link] and interpreters [link]. There is also a BSL version to explain the guidelines [link].
When we are unsure whether to go to A&E, the most common advice is to call 111, but how do you do this if you are deaf? For information in BSL, watch this video [link] for ways that you can contact 111.
Option 1: Relay UK
Relay UK [link] is a service that helps Deaf and hard of hearing people communicate over the phone, replacing NGT (Next Generation Text) and the former Text Relay service. It works by using a live relay assistant to help you communicate with the person on the other end of the call. The app will connect you to a relay assistant, who will:
type what the caller is saying so you can read their responses if you can’t hear
reads your written responses to the caller, if you can’t speak.
It is free to use the Relay UK service, so you only pay your normal phone charges.
Once you’ve downloaded the app, open it on your phone, tablet or computer.
Next, dial 18001 followed by the phone number (such as 111). If you’re using a smartphone with the Relay UK app, 18001 is automatically included before the number you want to dial.
You will then get a notification saying “outgoing call from [your number]… tap to join the text relay”.
Tap the notification or press 'join' on the app to join the call.
When the 111 adviser answers, the Relay Assistant will introduce the call and explain how the Relay UK service works if they have not used it before.
They will then type any of the adviser’s responses for you to read in the app - you can either type your reply or just speak as usual.
The 111 adviser will ask you the standard procedure questions and the relay assistant will type this out for you, as well as reading out any responses you type back to the adviser.
Note: If you end up needing to go to the hospital, the 111 advisers will inform the paramedics that you are deaf.
To use the Relay UK app with a textphone, go here for more info: [link].
Option 2: NHS 111 online
You can access NHS 111 online on a smartphone, tablet or computer at any time of the day. To use NHS 111 online, visit: 111.nhs.uk [link].
As with the usual method, you will first be asked:
- your current location
- that you are not in a life-threatening position.
- your gender and age
You can then search for the symptom that is most bothering you, and will then ask you any relevant procedure questions. If needed, you may be asked to either contact your doctor or emergency services.
Option 3: BSL interpreter
Here is a BSL version of the information about using InterpreterNow [link]. If neither of these ways work for you, you can also communicate with a 111 adviser via a BSL interpreter using the InterpreterNow app, you can download it here from Google Play [link] or here from the Apple Store [link]. Alternatively, if you want to use your computer and webcam, you can do so by going to this website [link].
Through the website or app, you make a video call to a BSL interpreter who then phones an NHS 111 adviser who interprets your conversation with the adviser.
The NHS 111 adviser will ask you questions about your symptoms, then give you the relevant advice or tell you which service can help.
When feasible, the 111 team will book you an appointment to the right department. If the adviser thinks you need an ambulance, they will arrange one for you immediately.
The NHS BSL video relay service is open from 8am to midnight every day.
When I lost my hearing and realised I could no longer make phone calls, my immediate worry was what I would do in an emergency, such as if I/someone close to me was in danger. Thanks to the emergencySMS service, the Deaf and hard of hearing community no longer have to worry about that! Here is a BSL about how the service works [link].
This service is an amazing result of a collaboration between: Action on Hearing Loss (formerly RNID), BT, Cable & Wireless, the Department of Communities and Local Government, OFCOM, the UK emergency services and all mobile network operators.
It means that Deaf and hard of hearing people in the UK can send an SMS text message to the emergency 999 service where it will be passed to the police, ambulance, fire rescue, or coastguard. The emergency service needed will then correspond to you by text and update you.
You must only text this service in an emergency, such as when:
Life is at risk;
Crime/trouble is happening;
Someone is injured or threatened;
A person committing a crime is near;
There is a fire or people are trapped;
You or someone close is in need of an ambulance urgently;
Someone is in trouble or missing at sea;
Someone is in trouble on the cliffs or on the shoreline
How do I register?
You will need to register your mobile with the emergencySMS service in order to use the emergency service.
To do this, you need to:
Send the word 'register' in an SMS message to 999
You will then receive SMS messages about the service
When you have read these texts, reply with 'yes'
You will receive a text telling you that your mobile phone is registered
How do I know if there is a problem with my registration?
You can check your mobile phone registration by texting the word 'register' to 999. You will receive a text telling you if your mobile phone is registered or if there is a problem with your registration.
If you try to register and do not receive a text from the emergencySMS service, check with your mobile provider to make sure they support the emergencySMS service.
If you still cannot register, I advise that you contact Action on Hearing Loss [link].
What do I need to send in a text when there is an emergency?
In an emergency, the 999 responders’ team have asked that you include:
- Who you need
Police, Ambulance, Fire and Rescue or Coastguard
- What has happened
Briefly, what is the problem?
- Where you are
Exactly where the problem is happening
Give the name of the road, house number, postcode or nearby landmark.
The emergency service will either ask for more information or will tell you that help is on the way.
Hopefully next time you need to use medical services, you can now do so with reduced anxiety!