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The Newcastle upon Tyne Hospitals NHS Foundation Trust

Interpreter and Translation Policy

Version No.: 8

Effective From: 23 April 2018

Expiry Date: 23 April 2021

Date Ratified: 01 March 2018

Ratified By: Health Equality and Wellbeing Committee

1 Introduction The Trust is committed to ensuring that everyone whose first language is other than spoken English receives the support and information they need to communicate with healthcare staff and to access health services. This will allow people to make informed decisions about the care they or the person they are responsible for or care for receive. Use of professional spoken language interpreters has been shown to improve clinical care and outcomes, use of services, patient satisfaction and to reduce communication errors (Karliner et al 2007). Equality Legislation and national guidance indicate that organisations should provide interpreters where they are required. The Equality Act (2010) states that public organisations have a duty to eliminate unlawful discrimination, harassment and victimisation, advance equality of opportunity between different groups; and foster good relations between different groups. Fulfilling this duty involves equal access to services and to positive health outcomes for those whose first language is other than spoken English. The Statutory Accessible Information Standard (2016) requires all health and social care providers to meet the communication and information needs of Deaf and disabled patients and their Carers. This includes asking about communication and information needs, recording, flagging and acting on this information and sharing it where appropriate. 2 Scope

This policy is intended to ensure that measures are in place to support communication with everyone whose first language is other than spoken English. This includes providing communication support for Carers and Young Carers. (A Carer is someone who helps to look after a patient and without whom the patient could not manage their day to day life.) Translation of written material is also included within the scope of the policy.

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3 Aims The policy provides advice to staff on how to book and work with interpreters and the process for translation of written materials. This will ensure that health professionals meet their professional accountability; providing an equitable service inclusive of effective communication which underpins all aspects of clinical care. 4 Duties (Roles and responsibilities)

4.1 The Executive Team is accountable to the Trust Board for ensuring Trust-wide compliance with guidance. 4.2 Directorate Managers and Heads of Service are responsible to the Executive Team for ensuring policy implementation. 4.3 Managers are responsible for ensuring policy implementation and compliance in their area(s). 4.4 Staff are responsible for complying with the policy

5 Definitions 5.1 Interpreting Interpreting is defined as the transmission of meaning from one language to

another, which is easily understood by the listener. This includes the conversion of spoken language into other spoken languages, British Sign Language (BSL), which is a recognised language in its own right, and other sign language.

It should be noted that interpreting is quite different to advocacy and should

not be used as a form of advocacy which involves the advocate in speaking up for, or acting on behalf of, the service user.

5.2 Translation

Translation is the provision of information in a format other than written English. This includes, for example, information in another language, easy read and electronic formats. The provision of translated material does not replace an interpreter, but can be used to supplement or reinforce information being given via an interpreter. It should be noted that, as for all people, some people whose first language is not spoken English may not be able to read information in their first language. Information should be appropriate to the person’s literacy needs.

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6 Interpreting

Health Professionals have an obligation to work with trained interpreters for patients who need this service. This will ensure that health professionals are able to carry out their duties and responsibilities. It is the health professionals’ responsibility to provide trained professional interpreters to patients as this ensures professional interpreting standards and accountability. The type, and method of provision, of interpreting that may be required is set out in Appendix A It is important to recognise that people who are able to communicate about basic issues may not have the ability to comprehend information about medical issues, especially when they feel vulnerable or stressed in hospital. In addition some people as they age lose their ability to communicate effectively in a second language, i.e. English.

If patients are referred or transferred to another service the need for an interpreter should be flagged on electronic records and documented in a prominent place in in paper records .

6.1 Identifying the Type of Interpreting Service Needed

Practitioners such as GPs referring patients to the Trust should highlight the need for language or communication support. If these needs have not been identified by the referrer, or if the patient is admitted as an emergency, the person assessing the patient is responsible for identifying the need for an interpreter. It is essential that the correct type of interpreting service is provided for the patient or Carer, if the patient is a child or person without mental capacity, for those with responsibility for the patient. Ask the patient, family or Carer about the best way to communicate. It is also important to establish whether the patient or Carer has a preference for a male or female interpreter.

The exact language and dialect of spoken language should be identified. For example people whose ethnic origin is Bangladeshi may speak Bengali or the Sylheti dialect of Bengali. Spoken language identification cards are available to help staff to identify spoken languages (Appendix B).

For Deaf people or people who are hard of hearing there are a number of communication methods. Examples are listed below; find out what the patient needs. British Sign Language Lip speakers Sign Supported English Note-takers Speech-to-text reporters

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Electronic note-takers For people who are Deafblind, Deafblind Communicator Guides and Interpreters may be needed

6.2 Recording the Need for an Interpreter Interpreting and communication needs should be clearly marked on patients Medical Records this includes the paper record and the electronic patient record. An ‘Alert sticker’, should be stuck on the front of the patient’s casenote folder,

and the requirement for interpretation services noted on the front sheet inside the notes.

On the patients electronic record, via Powerchart and within the problems tab “Interpreter required” should be recorded in either the “Accessible Information, Professional required” section or the “Alert” section.

The clinician receiving the referral, where the need for an interpreter is indicate is responsible for ensuring that this is highlighted, so the person responsible for booking an interpreter is informed. In accordance with the policy regarding the use of ‘Alert sticker’, an alert should be stuck on the front of the patient’s case folder, and the requirement for interpretation services noted on the front sheet inside the notes. Where e-records are used, this should also be recorded on e-record. It is the responsibility of the team who initially identifies the requirement to add an alert in line with e-record processes. The clinician receiving a referral, where the need for an interpreter is indicated, is responsible for ensuring that this is documented and the person responsible for booking an interpreter is informed.

6.3 Booking an interpreter

Details of the ‘theBigword’ Interpreting Service and the booking process can be found in Appendix C and D.

(i) For out-patient appointments, the clerk booking the appointment is responsible for booking the interpreter.

(ii) For elective in-patient or day case admissions, the person who

arranges the admission is responsible for booking the interpreter.

(iii) For community staff, the health professional in charge of the case is responsible for booking an interpreter; the task can be delegated to another member of staff but responsibility remains with the health professional.

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6.3.1 Booking Spoken Language Interpreters

Interpreters can be provided by telephone Interpreting or face to face interpreting. Telephone interpreting can be set up in minutes and can be used for the duration of a clinical interaction or to support care until a face-to-face interpreter is available, if required. Appendix A provides guidance to assist staff in deciding whether to use face- to- face or telephone interpreting. Telephone interpreting via conference call is also available; see Appendix E 6.3.2 Booking British Sign Language Interpreters

When booking BSL interpreters ask for advice on whether you will need one or two interpreters. This will largely depend on the length of the consultation or meeting. Ask if the patient or Carer requires a male or female interpreter and if they have any preferred interpreters; record this information. If possible, send the interpreter any preparation material in advance so that they know what to expect and can prepare as much as possible (e.g. for meetings, conferences etc.). The Trust uses a range of British Sign Language (BSL) Services. The details of BSL services and the booking processes can be found in Appendix F.

6.3.3 What to do if an interpreter does not arrive

Contact ‘theBigword’ to find out if there is a reason that the interpreter has not arrived and to report the issue to your line manager. Any ongoing concerns can be reported to the Head of Patient Experience. If a spoken language is required and if it is appropriate request a telephone interpreter until the issue is resolved or to explain to the patient what will happen next. If BSL interpreter has not arrived you can use the Video Relay British Sign Language Equipment by located at the main reception areas of the Freeman and RVI. Instructions for use are attached to the equipment. In Community Services you can use written language or the finger spelling web page http://deafsign.com/ds/ where you will be able to type in instructions; the on-screen translation service will convert to British Sign language. This is a very slow process and not appropriate for consultations. 6.3.4 What to do if an interpreter is booked and the patient does not arrive

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To promote access to services where patients may not be able to read a letter Trust staff can ask the interpreter to phone or text the patient, on Trust telephones, to find out why they not arrived and if possible re-book the appointment. The member of staff should instruct the interpreter on what is to be conveyed to the patient. If an appointment is to be re-booked Trust staff need to ensure an interpreter is re-booked

6.3.5 Patients or Carers checking if an interpreter is booked

Some patients or Carers will wish to check if an interpreter has been booked

prior to their appointment. The PALS Team have a process to support patients whose first language is other than spoken English and wish to find out if an interpreter is booked. They can contact PALS on:

Text/SMS: 01670511098

Website: www.newcastle-hospitals.org.uk/patient-guides/patient-

advice-and-liaison-pals.aspx

E-mail: northoftynepals@nhct.nhs.uk

Letter: FREEPOST, RLTC-SGHH-EGXJ, North of Tyne PALS, The Old

Stables, Grey’s Yard, Morpeth, NE61 1QD

6.4 Use of Trust Staff to interpret

It is not advisable to ask other employees who are bilingual to interpret as this takes them away from their normal duties and you cannot be sure of their ability to interpret accurately and impartially. Before asking staff to interpret all other means of communication such as BSL Video Relay and telephone interpreting must be explored. Only when these options have been exhausted should there be any consideration of asking staff to interpret.

Any staff interpretation should be limited to communication of basic information about care or personal details and not be used to interpret clinical information, medical terminology or to facilitate decision-making about clinical care and consent.

If more than basic information is needed, then an external approved interpreter should be arranged.

6.5 Use of Family, Friends and Carers to interpret

Family and friends and Carers should not interpret any clinical information whatever the patient’s age. Staff must be aware that family, friends and Carers interpreting may be inaccurate and biased due to for example, lack of language skills, emotional involvement and conflicting interests. It may also break patient confidentiality.

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Children should never be asked to interpret for anyone, including parents or siblings. There may be occasions when young people interpret basic information as set out in Appendix A

6.6 Safeguarding Where there are concerns about safeguarding issues (adults and children) or capacity issues, under the Mental Health Act and Mental Capacity Act, an approved external interpreter should always be used.

6.7 Working with Interpreters

6.7.1 Working with Spoken Language Interpreters

Consider the most appropriate method of translation. Will telephone translation provide you with what you require for the duration of the intervention or is it required until face-to-face interpretation is provided if required? Could you use it for some aspects of meeting a patient’s needs and have face-to-face interpretation at other times?

For face-to-face interpreting it is essential to check the interpreter’s identity and the job reference number when they arrive.

Before the interpreting session starts, it is important to spend some time with the interpreter to brief them, giving any appropriate background information and explaining any technical terms (for example medical or legal terms) that may arise.

After the interpreting session, it is advisable to discuss how the interview went and discuss any issues (for example, cultural differences).

6.7.2 Working with British Sign Language Interpreters

(Taken from the Action on Hearing Loss – Working with a BSL/English Interpreter Fact sheet – www.aactiononhearingloss.org.uk)

Check the interpreter’s identity and the job reference number when they arrive.

Positioning – The sign language user and interpreter need to see each other clearly. Interpreters will advise on the best place for them to sit or stand and will take into account the lighting and visibility.

It is good practice for only one person to speak at a time. It is impossible to interpret two people speaking simultaneously.

Avoid jargon and abbreviations.

Allow plenty of time when using visual aids as it will not be possible for the BSL user to study visual aids and watch the interpreter at the same time.

The interpreter needs time to comprehend and reproduce in English what has been signed in BSL and vice versa, so expect short time delays as this happens. This is especially important during questions and discussions.

Talk at a reasonable, normal speed and talk directly to the people you are communicating with and not to the interpreter.

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6.7.3 Working with a Deafblind interpreter

(Adapted from guidance on the deafblind uk http://deafblind.org.uk/ ) Before the appointment - Where possible:

Where the interpreter and/or the deafblind user or Carer do not know each other, arrange for them to meet at the venue before the appointment begins

Ensure that the interpreter receives details of the meeting and/or copies of relevant papers at least a week before.

Position of the Interpreter for Deafblind People

Because use of deafblind manual requires hand to hand contact, the deafblind user and the interpreter will need to be seated comfortably, side by side.

Some interpreters may prefer a chair without arms and if they need to refer to papers whilst working, a table at an appropriate height will be required.

During the meeting

Talk to the person not the interpreter

Only one message can be conveyed at a time so it is important that participants at meetings speak one at a time

Using the deafblind manual can be physically and mentally tiring for both the interpreter and the user. Breaks are needed every 20 minutes. For assignments of more than two hours it may be necessary to book two interpreters.

See Appendix G for more information about supporting the communication needs of Deafblind people

6.7.4 Working with an interpreter at a home visit

If you book an interpreter for a home visit, especially for the first visit, it is advisable to book the interpreter to meet with you in your office to brief them and then go to the client’s or patient’s home together. This allows you to have a safe environment to brief the interpreter and to ensure that the interpreter is not alone with the client or patient.

For a follow-up appointment, if you feel it is safe for the interpreter to work with you in the client’s or patient’s house, you can book the interpreter to travel there directly. However, interpreters will wait for you outside the client’s or patient’s home; they are not allowed to enter on their own.

We would therefore ask you to wait for the interpreter in front of the client’s house and to give them the briefing either in your car or in the interpreter’s car.

If you are late or are not able to attend, it is essential that you inform ‘thebigword’ of the expected time of your arrival, or the interpreter will leave the location after waiting 20 minutes past the appointment time.

Consider continuity of care. It is not appropriate to book a follow-up interpreting appointment directly with the interpreter. If a follow-up

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appointment is needed, you must make the booking directly with ‘thebigword.’ You will have the option to request the same interpreter who was previously used.

6.7.5 Health and safety for interpreters

Interpreters are required by ‘thebigword’ to work in line with the health and safety requirements of their contract and their code of conduct. You should consider whether any health and safety precautions that you take when undertaking your duties should also be applied to the interpreter. For example: It is important any interpreters attending a patient in isolation are advised of the necessary isolation precautions required prior to entering the isolation area; they should not be informed of what the infection is as this would breach confidentiality. In the case of an interpreter needing to be immune to a condition in order to enter the room staff should ask the interpreters whether they have been vaccinated for the specific condition. For example in the case of Measles, they should be asked if they have received the MMR vaccine and not enter an isolation area without knowing they are immune. The link here should provide more information on this. http://policies.app/Launchit.asp?launchit=181 If you wear a mask when you are examining a patient, you should also offer the same protection for the interpreter who is standing next to you. Interpreters may not wish to wear a mask as it may interfere with interpreting. The risks and the one metre rule should be explained to them and they can then decide whether they wish to continue. This advice may change in an outbreak situation but individual clinical areas would advise any staff entering an affected area if additional precautions were temporarily implemented. http://policies.app/launchtext.asp?LaunchIt=5090 http://policies.app/Launchit.asp?launchit=205 Staff must make sure that interpreters are protected from environmental risks and equipment which is being used in an interpreting session. For example during diagnostic procedures.

Make sure that the interpreter knows where the antibacterial gel is located.

Interpreters should not be asked to help with any clinical tasks or to touch any bodily fluids.

6.7.6 Interpreters transporting patients

Interpreters are not responsible for providing transport to take patients to or from home. If a patient requests this service, the interpreter should let you know.

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6.8 Translation

Information about translation services are outlined in Appendix I In addition consider the use of Easy Read and pictorial information to support communication for people whose first language is other than spoken English

7. Training

Interpreting is included as part of Staff Induction training

Guidance is available on the intranet. 8. Equality and Diversity The Trust is committed to ensuring that, as far as is reasonably practicable, the way we provide services to the public and the way we treat our staff reflects their individual needs and does not discriminate against individuals or groups on any grounds. This document has been appropriately assessed. If patients whose first language is other than spoken English need support to raise a concern or to complain about the Interpreting Service, the Patient Advice and Liaison Service can support them. PALS will enable them to access any language support they need in relation to the concern or complaint. 9. Monitoring compliance

Standard / process / issue

Monitoring and audit

Method By Committee Frequency

To ensure that interpreter services are provided in line with the patient population we serve.

Compare Newcastle population of people who cannot speak English – 1.8% https://visual.ons.gov.uk/language-census-2011/ with the % of patient contacts supported by an interpreters

E&D Lead.

Health Equality and Well-Being Steering Group.

Annually.

Understand the experience of patients who have interpreter support to communicate

Review PALS and the Health and Race Equality Forum feedback. Review complaints in relation to interpreting.

E&D Lead

Health Equality and Well-Being Steering Group.

Annually.

10. Consultation and review The policy has been reviewed by the Health and Race Equality Forum, Deaf Link and the Equality Diversity and Human Rights Group

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11. Implementation (including raising awareness) A summary of the key changes will be notified to Matrons and Clinical Directors. Awareness will be raised through the Trust Intranet and Communication Forums Further advice and guidance will be available from The Trust’s Equality and Diversity Lead 12. References This policy is based on evidence within: Interpreting support in health and social care consultations: Experiences and views of people in some black and minority ethnic communities in Newcastle upon Tyne (2010) McNulty, A. Ahad, D. Accessible Information Standard (2016) https://www.england.nhs.uk/ourwork/accessibleinfo/

A Practical Guide to Commissioning Face to Face Language Interpreting Services(2011) Roberts, A. et al Action on Hearing Loss – Face to Face (2012) www.actiononhearingloss.org. Deaf Blind UK Cause and Cure Deaf Blind people’s experience of the NHS (2009) 13. Associated documentation Associated Documents can be found on the Trust Intranet Site at: http://nuth-vintranet1/cms/SupportServices/InterpreterServices.aspx

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Appendix A Summary of Interpreter Use

Type of Communication

Examples Type of Provision Available

Basic Needs Personal demographic details, discussions/help on toileting and feeding. Reinforcing health messages that have previously been discussed.

If family members interpret for basic issues, it is important to bear issues of accuracy and confidentiality in mind. If there are any concerns about safeguarding issues, an external interpreter must be used even for basic communication. Telephone Interpreting. British Sign Language by Video Relay Language cards can be used. The British Red Cross Society’s Multilingual Emergency Phrasebook (see Appendix C).

Intermediate and Advanced Needs

Assessment, investigations, treatment, explaining diagnosis, referral to other services and discharge issues and for anything complicated.

Approved external interpreter, via telephone or face to face. The professional’s clinical judgment in discussion with the patient should be used to decide whether telephone or face-to-face interpreting is used.

Discussions about Safeguarding Children and Adults. Safety issue

When there are concerns about safeguarding children or adults. Issues related to Mental Capacity and Domestic Violence.

Approved external interpreter, direct face-to-face interpretation even for basic communication.

Obtaining Consent

When obtaining consent for an investigation or treatment, an interpreter must be used to ensure that the patient or person with parental responsibility or power of attorney understands the full procedure planned. Details of the interpreter or service used must be documented on the consent form.

Approved external interpreter. Direct face-to-face interpretation

Early stages of unplanned / unscheduled care

E.g. A&E, MIUs, Out of Hours, MAU, emergency maternity admissions. Drop-in clinics

British Red Cross Emergency multi-lingual phrasebook. Telephone interpreting.

Appendix B is on the following page. This can be printed for patient identification of languages

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Appendix C - booking process spoken languages- summary

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Appendix D - Booking process- detailed information

1. Online booking of an Interpreter via Language Director®

The Bigword has an online portal called Language Director®, which should be utilised by staff to book their interpreters. This is the preferred method of booking for Newcastle NHS Foundation Trust. Using the electronic booking form – see guide below

How to book guide.pptx

In order to access the site, the staff require a username and password. This can be requested from thebigword ukgovinterpreting@thebigword.com 0113 210 7414, who will send an email with the details.

1.1 Normal Hours Requests

Booking requests can be made to thebigword, which is open 8 am to 6pm.

As much notice as possible should be given but efforts will always be made to fill requests made at short notice. At least 48 hours is the standard time for requests. Information about the session is requested in order to allocate a suitably trained and experienced interpreter. The patient or staff member may express a preference for an individual they have worked with before. The Bigword will attempt to satisfy that requirement.

1.2 Out-of-hours Requests

Bookings can be made using the online portal 24/7 as it is the quickest method.

Thebigword can also be contacted on 0800 757 3100 and they will be able to provide immediate telephone interpretation support for you and seek face-to-face interpretation if required and will advise on availability.

1.3 Request Via Fax

Only to be used as a last resort Bookings should be made on a customised booking form, detailing your directorate, Patient MRN number, DOB and Surname. Please note this information is mandatory to complete the booking. You need only add the details of the individual request. Please provide as much detail as possible, to enable the selection of an appropriate interpreter.

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The Fax number is: 08707488111 Please do not send your fax through more than once. You will receive confirmation that an interpreter is booked via fax. thebigword works on a priority level; therefore if your booking is for months in advance you will receive notification closer to the appointment. The confirmation you receive is the timesheet, which details the interpreter’s details, the date, duration and contact details for the person who has requested the booking and also how to contact thebigword. This timesheet should be signed by the person who conducted the meeting and then given back to the interpreter. The exact time should be entered on to the time sheet with no rounding up or down. If you have any concerns about your booking or wish to amend it, please email the Bigword at ukgovinterpreting@thebigword.com or call the Interpreting team at thebigword on 0800 757 3100

1.4 Telephone Interpreting

All staff members should be fully trained in accessing a telephone interpreter and be able to request the interpreter directly.

1.5 Step-by-step Guide

i. Dial 0800 862 0653. ii. Enter your eight digit Access Code followed by the # key. iii. Enter the Language Code required followed by the # key. (E.g. Polish = 5#, Cantonese = 93#) For assistance, enter 0# as your language code to connect to an Operator. They can help with any queries or assist you in the process. For example: • if you know the language you need but can’t find the relevant code; • if your client has requested to speak to a gender-specific interpreter. Enter 700# as your language code if you cannot figure out what language you require. A team of linguists can work with your client to figure out the language you require. iv. Wait on the line to be connected to an interpreter. Ways of using the service with people who need support to understand information in English. There are three ways in which you can use the service with people who need support to understand information in English. The process may differ slightly depending on your phone system.

Your Patient is with you in Person i. Follow the step-by-step guide to connect to an interpreter.

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ii. When the interpreter is on the line, either use thebigword dual handset, put the interpreter on loudspeaker or simply pass your telephone handset between yourself and your patient. You receive a Call from a Patient i. Put the patient on hold using the conference button (opens up a

second line) ii. Follow the step-by-step guide to connect to an interpreter. iii. When the interpreter picks up, give them an outline of the situation. iv. Conference in your patient using the conference button. You Need to Call a Patient i. Follow the step-by-step guide to connect to an interpreter. ii. When the interpreter picks up, give them an outline of the situation and

inform them you will be calling your patient. iii. Put the interpreter on hold using the conference button (opens up a

second outside line). iv. Dial your patient’s number. v. Conference in the interpreter using the conference button before your

patient answers. If there is no conference facility on the phone, please follow the step-by-step guide and press 0# to go through to the call centre. thebigword can facilitate the 3-way call.

2. If thebigword Cannot Provide Cover

thebigword may sometimes be unable to supply an interpreter at the specified appointment time and will let you know this within the target response times. Consideration may be given to using telephone interpreting, which thebigword can set up for you, or to altering the appointment to a time when an interpreter is available.

3. Continuity of Cover

To assist in the provision of continuity of care, you may wish to ask the interpreter you have worked with to return for a follow-up appointment.

4. Cancellations

By the Interpreter: occasionally an interpreter may find themself unable to honour an appointment. They will inform thebigword office, who will attempt to find a replacement and will keep the Trust informed of what is happening. The Trust will be notified with at least two hours’ notice of the appointment commencement time.

By the Professional: if the Trust needs to cancel the appointment for any reason, give us as much notice as possible so that the interpreter can be

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re-assigned. If cancellation is within 24 hours, there will be a charge for the session.

5. Validation / Payment of Attendance

Once the session with the interpreter is finished, the professional will sign the timesheet. The interpreter then sends this to thebigword for verification. All of the timesheets signed by the Newcastle staff are attached to the invoices for each directorate, which are then cross-referenced with each booking on the invoice by the invoice approver.

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Face-to-Face Request Form

To: UK Government Team Contact Details: ukgovinterpreting@thebigword.com thebigword 0800 757 3100

Well Court 0870 748 8111 (fax)

14-16 Farringdon Lane www.thebigword.com/client/UKGov/ London EC1R 3AU

Your Details Please choose site for the interpreter

Contact Name Freeman RVI

Contact Number

Newcastle General Walkergate

Email Address Centre for Life

Other-please specify

Fax Number

(MANDATORY)

Directorate/Department

Please specify location (e.g. ward)

Onsite Contact / Professional’s Name

Contact Number Preferred Gender Male Female

Patient’s MRN number Language Required

Patient’s Surname

Appointment Date

Patient’s D.O.B

Any additional instructions

Start Time

Approximate duration

Nature of Appointment

All assignments are treated in the strictest confidence. If you believe this assignment is particularly sensitive, please tick this box:

thebigwordGroup will source an interpreter for you when we receive this form. Once an interpreter has been sourced we will contact you with further details.

thebigwordGroup – Other Services Translation Telephone Interpreting

Government Framework Reference: Tel:

Fax: Email:

05/GEN/25 0870 380 0711 0870 458 0552

ukgov@thebigword.com

912/CAG/0137 0800 321 3025 0870 748 8111

tis@thebigword.com

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Appendix E Conference Call

Appendix F - Booking BSL Interpreters

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For all patients whose appointments within the Trust is planned or booked either as an inpatient or outpatient, the following procedure is to be followed: Newcastle and North Tyneside Patients (and patients from outside of the area - excluding Sunderland, Gateshead or South Tyneside, for which see below). Booking interpreter support is via thebigword

During office hours (8am-6pm) - If the request is for a date in the future or if it is an urgent request during office

hours, use the BSL booking form on the intranet. - E-mail it to ukgovinterpreting@thebigword.com or fax to 0800 321 3017. - You can also call 0800 757 3100 and press 1 to make a booking. - You can say if a patient has a preference for a particular Interpreter. Note - The BSL provider will send confirmation to the patient regarding the booking. Please ensure that the patient’s contact details are completed on the booking form.

Emergency / Urgent request out of hours

British Sign Language by Video Relay can be used. This is available at all the main reception desks in the Freeman and RVI. Instructions for use are attached to the equipment or can be found on: http://nuth-intranet/cms/SupportServices/EqualityDiversityHumanRights/CommunicationSupport.aspx - If the booking is urgent and required immediately, please telephone thebigword on

0800757 3100. At Patient’s Own request: Becoming Visible: If a patient requests an interpreter from Becoming Visible, the request needs to go through thebigword. .Specify in the notes that you are requesting the interpreter (include their name) from Becoming Visible. Gateshead, Sunderland or South Tyneside Patients If a patient requests an interpreter from Northern Sign the request needs to go through thebigword. Specify in the notes that you are requesting the interpreter (include their name) from Northern Sign. Contact details are below:

Email: northernsign@blueyonder.co.uk

Fax: (0191) 441 25 52 - Tony Beckett

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Email: mail@northernsign.co.uk

Tel: 0191 529 4652 / 0771 092 2138

Mobile contact only on Tel: 0771 0922 138

If a person arrives who is deaf and unable to speak, you can:

If you have exhausted all other options you can use deafsign to hold an initial conversation until appropriate communication is found.

Use the internet to access http://deafsign.com/ds/ and you will be able to type in instructions; the on-screen translation service will convert to British Sign language. This is a very slow process. Some patients may prefer to type onto a word document rather than using a pen and paper

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Appendix G Communicating with Deafblind people The information below is adapted from guidance on the deafblind uk and Action on Hearing Loss. For further information access websites https://deafblind.org.uk/deafblindness/communication/ https://www.actiononhearingloss.org.uk/live-well/communicate-well/communication-tips/tips-for-communicating-with-deafblind-people/

Most people who are Deafblind have a little sight and / or hearing they can use – but there are a few people who are completely deaf and blind. Deafblind people use a red and white striped cane.

Deafblind people use many different methods of communication. The method, or methods used will depend on the amount of residual sight and hearing and any additional disabilities the individual has. It will also depend on whether the individual has learned formal language before becoming Deafblind. 75% of Deafblind people can manage communication with clear speech- louder, slower, clearer

Top Tips:

Be aware that communication often requires a great deal of

concentration and effort for a person who is Deafblind and can be tiring

for them

Take your time. Be patient – communication may take a lot longer

Consider the environment, such as lighting and background noise. If

lighting changes, for example, moving from low light to bright light a

person’s eyes may need time to adjust.

If the person uses hearing aids make sure there is a loop system

available

Ask about the best way to communicate and record this in a

prominent place in the person’s notes. Communication may for

example be through clear speech, writing notes or computer screen in

large print, braille, finger spelling. See appendix 1for finger spelling.

Simplify what you want to say so that it is not a long sentence e.g. tea?

If Deafblind people lip read they may need to be close to the person

speaking.

Book an interpreter as soon as possible.

Pass on information about communication needs to all staff working

with the person. Use the electronic alert in patient records

Use vibrating pad in clinics to attract Deafblind patient’s attention

Ask if the person needs a guide when moving and if they do ask the

best way to guide the person

Page 24 of 25

Appendix H -Translation of Written Materials Please make sure that the information you require is not already available on the Trust Intranet site or national sites. Disease-specific sites such as Diabetes UK have translated information. The Knowledge Service (part of the Library Service) may be able to help you find information. http://www.ntw.nhs.uk/pic/languages.php is a useful site for information in other languages on a number of topics. All requests for translation of written information into other formats (languages, Braille or audiotape) should be directed via the Supplies Department. They will approach an approved translation company, which will provide translations of information within agreed timescales, quality standards and formats. Information in other formats should be requested only when a specific need is identified in order to ensure that the information is up to date at the time of production. Please note that confidentiality should be maintained at all times when any patient-identifiable information is translated. The following services can be provided:

Written information in other languages.

Audio tapes.

Braille (English).

Easy-read versions of documents, leaflets, etc.

BSL Signed video Managers should be aware that funding for specific pieces of information to be translated will continue to be provided from individual directorate budgets. How to access translation services:

1. For patient information leaflets ensure the document has been approved by the Patient Information Review Panel

2. Identify format/s required (language/Braille/Audiotape). 3. Complete a non-stock requisition and forward to the Supplies Department with

cost centre and account details in the usual manner and attaching a copy of the information required.

4. Supplies department will request an electronic version to e-mail to the translation company with a request specifying the language/format required and agree a cost and turnaround time.

5. The company will translate the information and present it in a similar layout to the original.

6. All work will be proof-read. 7. The information will be returned to the Trust in the agreed format. 8. Where appropriate, translated information will be added to the Patient

Information site for future reference.

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Appendix I - Red Cross Multilingual Phrasebook The language you require can be downloaded and printed as required from: http://webarchive.nationalarchives.gov.uk/20130105192116/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4073230 This multilingual phrasebook has been designed for use in medical emergencies where the patient does not speak English. It contains a list of essential questions in 36 languages, with English translations. It will enable basic communication between first contact carers and patients in some emergency situations. The phrasebook is not suitable for long-term use with individual patients and should not be seen as a substitute for a trained interpreter.

Multi-lingual hard copies are available at all reception points, Walk In Centres and the Emergency Dept.

Interpreter and Translation policy EA 2018 Page 1 of 5 Dec 2013

The Newcastle upon Tyne Hospitals NHS Foundation Trust Equality Analysis Form A

This form must be completed and attached to any procedural document when submitted to the appropriate committee for consideration and approval. PART 1 1. Assessment Date: 24/02/2018 2. Name of policy / strategy / service:

Interpreter and Translation Policy

3. Name and designation of Author:

Frances Blackburn; Deputy Director of Nursing and Patient Services (Freeman)

4. Names & Designations of those involved in the impact analysis screening process:

Lucy Hall; Equality and Diversity Lead, Vicki Harris; Heath and Race Equality Forum Coordinator, Dianne Murphy; Deaflink , Rachel Parsons; Newcastle Carers

5. Is this a: Policy x Strategy Service

Is this: New Revised x

Who is affected: Employees x Service Users x Wider Community x 6. What are the main aims, objectives of the policy, strategy, or service and the intended outcomes? (These can be cut and

pasted from your policy)

The policy provides advice to staff on how to book and work with interpreters and the process for translation of written materials. This will ensure that health professionals meet their professional accountability; providing an equitable service incorporating effective communication which underpins all aspects of clinical care.

Interpreter and Translation policy EA 2018 Page 2 of 5 Dec 2013

7. Does this policy, strategy, or service have any equality implications? Yes x No These have been addressed within the policy If No, state reasons and the information used to make this decision, please refer to paragraph 2.3 of the Equality Analysis Guidance before providing reasons:

8. Summary of evidence related to protected characteristics

Protected Characteristic

Evidence i.e. What evidence do you have that the Trust is meeting the needs of people in various protected Groups related to this policy/service/strategy – please refer to the Equality Evidence (available via the intranet Click A-Z; E for Equality and Diversity. Summary on front page and more detailed information in resources section)

Does evidence/engagement highlight areas of direct or indirect discrimination? If yes describe steps to be taken to address (by whom, completion date and review date)

Does the evidence highlight any areas to advance equal opportunities or foster good relations. If yes what steps will be taken? (by whom, completion date and review date)

Race / Ethnic origin (including gypsies and travellers)

The policy is designed to improve communication between patients and Carers whose first language is not English and staff. Mandatory EDHR training Provision of interpreters

14.6% of the local population are from minority ethnic communities. There is no overall evidence about the number of people who have English as a second language but 14% of school local school children have a first language other than English. Use of professional spoken language interpreters has been shown to improve clinical care and outcomes,

Review training delivered in relation to working with interprets and develop good practice guidance. LH Oct 2018

Interpreter and Translation policy EA 2018 Page 3 of 5 Dec 2013

use of services, patient satisfaction and to reduce communication errors (Karliner et al 2007). These issues have been taken into account in the policy.

Sex (male/ female)

The policy refers to requesting a male or female interpreter if required Mandatory EDHR training

No No

Religion and Belief

The Chaplaincy team are available to support patients and staff regarding religious needs which may need interpreting. Mandatory EDHR training

No No

Sexual orientation including lesbian, gay and bisexual people

Mandatory EDHR training

No No

Age

The policy states that children should not be asked to interpret

Older people may be less likely to speak English Older people with dementia who have been fluent in English can lose their second language. Children may not have the knowledge and maturity to interpret and should not be asked to do so. These issues have been considered in the policy

Review training delivered in relation to working with interprets and develop good practice guidance. LH Oct 2018

Disability – learning difficulties, physical disability, sensory impairment and mental health.

The policy is designed to improve communication between disabled patients, carers and staff. The policy guidance states that carers and family should only interpret basic information BSL Video Relay introduced

Because of lack of communication

support nationally Deaf people have

been shown to have delayed diagnosis

of hypertension and poorer control of

long term conditions.

http://bjgp.org/content/65/631/95.short

Review training delivered in relation to working with interprets and develop good practice guidance. LH Oct 2018

Interpreter and Translation policy EA 2018 Page 4 of 5 Dec 2013

Consider the needs of carers in this section

Accessible Information Standard implemented within the Trust

Action on Hearing Loss estimates that there are more than 10 million people in the UK with some form of hearing loss, or one in six of the population. From the total figure, around 6.4 million are of retirement age (65+) and about 3.7 million are of working age (16 – 64). Confidentiality and accuracy may be compromised by family and carers interpreting. These issues have been considered in the policy

Gender Re-assignment

Mandatory EDHR training

No No

Marriage and Civil Partnership

Mandatory EDHR training

No No

Maternity / Pregnancy

Mandatory EDHR training

When interpreters are used in labour this has been shown to reduce the number of sections and forceps delivery.

No

9. Are there any gaps in the evidence outlined above. If ‘yes’ how will these be rectified ?

No

10. Engagement has taken place with people who have protected characteristics and will continue through the Equality Delivery System and the Equality Diversity and Human Rights Group. Please note you may require further engagement in respect of any significant changes to policies, new developments and or changes to service delivery. In such circumstances please contact the Equality and Diversity Lead or the Involvement and Equalities Officer.

Interpreter and Translation policy EA 2018 Page 5 of 5 Dec 2013

Do you require further engagement No

11. Could the policy, strategy or service have a negative impact on human rights? (E.g. the right to respect for private and

family life, the right to a fair hearing and the right to education?

No; this policy supports human rights principles

PART 2 Signature of Author

Lucy Hall

Print name

Lucy Hall

Date of completion

19/03/2018

(If any reader of this procedural document identifies a potential discriminatory impact that has not been identified, please refer to the Policy Author identified above, together with any suggestions for action required to avoid/reduce the impact.)