1. Accessible Information Standard Interpreting and Translation Standards Lisa Hilder October 2015

2. Summary On 24 th June 2015 The new Accessible Information standard was approved by NHS England Aim To make sure that people who have a disability, impairment or sensory loss get information they can access and understand and any communication support that they need. Ensuring this information is in a format they require, i.e. large print, braille, easy read or via email By 31 st July 2016 All organisations that provide NHS or Adult Social Care services must follow the standard in full. This includes NHS Trusts & Foundation Trusts, and GP practices. Organisations that commission (pay for and make decisions about) NHS and adult social care services must also make sure that they support the standard

3. Aim of the Standard (why) The aim of the Standard is to establish a framework and set a clear direction such that patients and service users (and where appropriate carers and parents) who have information or communication needs relating to a disability, impairment or sensory loss receive: ‘Accessible information’ (‘information which is able to be read or received and understood by the individual or group for which it is intended’); and ‘Communication support’ (‘support which is needed to enable effective, accurate dialogue between a professional and a service user to take place’); So that they can access services appropriately and independently, and make decisions about their health, wellbeing, care and treatment.

4. What does the accessible information standard tell organisations to do? Organisations that provide NHS or adult social care must do five things: Ask people if they have any information or communication needs, and find out how to meet their needs Record those needs clearly and in a set way Highlight or flag the person’s file or notes so it is clear that they have information or communication needs and how to meet those needs Share information about people’s information and communication needs with other providers of NHS and adult social care, when they have consent or permission to do so Take steps to ensure that people receive information which they can access and understand, and receive communication support if they need it

5. Timescales (when) Organisations may begin to follow the Standard immediately following publication of the Information Standards Notice (ISN). Organisations must comply by 31 July 2016. The standard does not apply directly to CCGs however there are requirements placed upon us to assist and support our providers to comply

6. An example of practice which will be required Conversation supported by a British Sign Language interpreter Receptionist: Do you have any information or communication support needs? Patient: Yes, I am Deaf. I need a British Sign Language interpreter at my appointments. Receptionist: Ok, I will record that in your notes. Do you need any other support from us? Do you need us to send you information in a particular format or contact you in a particular way? Patient: I cannot use a telephone. I need you to contact me via email or text message instead. Receptionist: Ok, I will record that in your notes too. Do you need any other support, or is there anything else you think we should know? Patient: I will need a longer appointment because the conversation will be three-way because of needing an interpreter. Receptionist: Ok.

7. More Information There is more information about the accessible information standard, including the Specification and Implementation Guidance, on the NHS England website at www.england.nhs.uk/accessibleinfoon the NHS England website www.england.nhs.uk/accessibleinfo More information, including more information in alternative formats, will be published on the NHS England website during summer and autumn 2015. Charities including Action on Hearing Loss, CHANGE, Sense, and the Royal National Institute of Blind people (RNIB) will also be publishing informationAction on Hearing LossCHANGESenseRoyal National Institute of Blind people (RNIB) The ‘Information Standards Notice’ which is the formal document which tells organisations that they must follow the standard is published on the Health and Social Care Information Centre website at www.hscic.gov.uk/isce/publication/scci1605Health and Social Care Information Centre website www.hscic.gov.uk/isce/publication/scci1605 For more information please email NHS England at england.nhs.participation@nhs.net or call 01138 253002. Or you can write to Accessible Information Standard, NHS England, 7E56, Quarry House, Quarry Hill, Leeds, LS2 7UE england.nhs.participation@nhs.net

8. JULY 16 – ARE YOU READY? ASK REMEMBER identify communication/information needs at patient registration or upon an existing patient’s next contact with the Practice Raise awareness amongst your staff – it’s known that a lot of staff lack confidence when trying to support individuals with communication needs Identify staff groups that will be doing the “asking” Provide training where required including how to record identified needs clearly and unambiguously ASK Review your letters and documentation – are they in a suitable font ie Calibri or Arial? (Don’t use Times New Roman). Can they be converted into easy read? What arrangements do you have in place for translation into braille or other languages? Patients should be able to identify their needs to you face to face or in a written format – what arrangements have you got in place to enable them to do this? If a patient elects the face to face option you have to offer them a private room for the conversation to take place in RECORD All recording needs to be clear and unambiguous Methods of recording need to be standardised across electronic and paper records/systems The patient, carer or parents should be asked to view and verify the accuracy of the recorded information Some patients may need multiple support options. If deaf an individual may have a hearing aid but could also lip read. Contact from the Practice would need to be by letter, e-mail or text rather than phone

9. JULY 16 – ARE YOU READY? ALERT, FLAG OR HIGHLIGHT Make sure that recorded needs are highly visible and seen immediately a record is accessed High visibility can be achieved by placing a need on the front cover, title, or front page of a document whether it’s a paper or electronic record Place a flag or alert banner on each page of an electronic record On a paper record consider using bold fonts and different colours to draw attention A regular review needs to be carried out to ensure the information is up to date. Put in a prompt system to remind staff to check and amend information when the patient visits SHARE Obtain consent to share a patient’s communication/information needs as part of their shared and integrated records Include details of any known communication/ information need when referring the patient within and between other organisations ie secondary care Sharing communication/information needs should be routine when providing referral and handover information ACT How will you provide a minimum of 2 ways for patients to identify their needs to you ie written or face to face? What methods will staff use to contact someone with a known communication or information need? How will you provide information, correspondence and advice in an accessible formats Do your systems need adjusting to provide prompts and flags where a need has been indicated? The Implementation Plan provides a lot of practical information and examples to help you and can be accessed at www.england.nhs.uk/accessibleinfo www.england.nhs.uk/accessibleinfo

10. This easy read booklet will tell you what people thought of our ideas and what will happen next. Hyper-Acute Stroke Care - Why we need to change? When a person has a stroke we know that the first few hours after the stroke are really important. If a person gets the right treatment quickly they have a good chance of getting better. When a person has a stroke the treatment that should be given during the first 72 hours is called Hyper-Acute Stroke Care. 72 2

11. Ideas for Hyper-Acute Stroke Care 6 Idea 1 What’s good about this idea?What’s not good about this idea? Idea 1: To have 24/7This would mean thatTo be able to do this Hyper-Acute Strokeanyone who had awe would need skilled Care at Scunthorpestroke in our local areastaff at both sites and General Hospital andwould be able to getlots of new equipment. Diana Princes Of Walestreatment at theirThis would cost a lot of Hospital.nearest hospital.money. It would be hard to get the right number of properly trained staff to keep people safe. If we do not have the right staff more people may die or have a poorer quality of life. Because of this we think that having Hyper- Acute Stroke Care at both hospitals will not work well.

12. Interpreting and Translation Standards Current consultation by NHSE on guidelines and standards for Interpreting and translation Recognition of the contribution to quality healthcare of clear and accurate information/communication

13. Why is this being undertaken Language barriers in the health care setting can lead to problems such as denial of services, issues with medication management, and underutilisation of preventative services It is estimated that around 17% of the general population have deafness and will have a range of communication related requirements. The 2011 UK Census indicated that 8% of the population spoke a main language other than English

14. 8 Principles for High Quality Interpreting & Translation Services 1.Access to Service - Patients must be able to access primary care services in a way that ensures their language and communication needs do not prevent them receiving the same quality of healthcare as others. 2.Booking of Interpreters - Staff working in primary care provider services should be aware of how to book interpreters across all languages including BSL and to book them when needed 3.Timeliness of Access - Patients requiring an interpreter should not be disadvantaged in terms of the timeliness of their access. 4.Personalised Approach - Patients can expect a personalised approach to their language, communication and access requirements recognising that “one size does not fit all”. 5.Professionalism and Safeguarding - High ethical standards, a duty of confidentiality and safeguarding responsibilities are mandatory in primary care and this duty extends to interpreters 6.Compliments, Comments, Concerns & Complaints - Patients and clinicians should be able to express their satisfaction with the interpreting service in their first or preferred language and using multiple formats (written, spoken, signed etc.) as appropriate 7.Translation of documents - Patients and healthcare professionals should have timely access to appropriately and effectively communicated documentation that will enable and support their healthcare. 8.Quality Assurance & Continuous Improvement - The interpreting service should be subject to systematic monitoring for quality assurance and to support continuous improvement to ensure it remains high quality and relevant to local needs.

15. Legislation and regulation Section 13G of the NHS Act 2006 (as amended by the Health and Social Care Act 2012), states that NHS England, in the exercise of all its functions, must have regard to the need to reduce inequalities between patients with respect to: – a) Their ability to access health services and – b) The outcomes achieved for them by the provision of health services. Section 29 Equality Act 2010 requires that all organisations providing a service to the public are subject to non- discrimination rules and ensure that they do not treat someone worse, or do something that has an adverse impact due to them having particular protected characteristic Section 13Q of the NHS Act requires commissioners to involve service users in a way that meets their communication needs

16. Any Questions?