NewsFAIR. Special Edition on Sensory Loss. The Dental Clinical Board Demonstrates its Commitment To Equality And Diversity

Transcription

1 NewsFAIR Understanding Equality & Diversity Special Edition on Sensory Loss The Dental Clinical Board Demonstrates its Commitment To Equality And Diversity Equality Diversity And Human Rights Whose Responsibility Is It Meeting Health Care Standards for Wales Bwrdd Iechyd Prifysgol Caerdydd a r Fro Cardiff and Vale University Health Board Cardiff Dental Clinical Board Issue no.4 - July 2015 Edited by Sharon Matthews

2 Introduction Cardiff and Vale University Health Board (UHB) will be the flagship UHB in Wales, with an international reputation for excellence and innovation. Our skilled and committed staff will provide safe, high quality care, at the right time, in the right place. University Health Board Statement of Intent The purpose of this briefing is to provide staff within the Dental Hospital with a brief overview of current issues (Equality Act 2010) and true Life Stories that will enable us to reduce health inequalities. This NewsFair has been compiled by the General Anaesthetic Theatre staff, University Dental Hospital Cardiff. Led by the UDH Equality Champion Sharon Matthews. Equality Training is a requirement for all employees within the University Health Board. Contents: 4 6 All Wales standards for accessible communication and information for people with sensory loss Interview with Margaret Mclaughlin We would like to hear your views on this newsletter. We would also appreciate any suggestions or contributions towards the next news briefing Emily s Story - A positive story for a Cardiff client accessing hearing assessment A thank you from Laura, a blind patient of the University Hospital of Wales Introducing Grace Garnett - Enhancing communication for people who have hearing loss Learning to lipread - Wales Council for Deaf People A patient case study Rainbow LGBT Fflag Network. Interested in Learning Welsh? Wales Vision Strategy Conference Please contact: sharon.matthews2@wales.nhs.uk ext jacqueline.hall2@wales.nhs.uk ext Improving Access for British Sign Language Users - British Deaf Association

3 Editorial I was asked by the Dental Clinical Board to represent them at the All Wales Sensory Loss Standards Workshop, in early December I also recently attended the Wales Vision Strategy Conference. On listening to patient s stories and experiences, to say I was humbled does not begin to describe what I felt. As a nation should we be more aware of how our behaviour impacts negatively on people who have a sensory loss. I believe it is not because we are uncaring or inconsiderate, rather that we have no concept of how our everyday behaviour may cause problems to others. It is a matter of just thinking before doing. For example: - We may complain and feel frustrated about parking our cars when spaces are limited. However, we should be considering people with a visual loss who are forced to walk in the road because of a vehicle that has parked on a pavement. Another example is when patients with hearing impairment attend their hospital appointments and miss their name being called because we have not taken into account that they may be deaf or hard of hearing. I think that from a perspective of health care service providers, we need to be aware that we must make reasonable or different adjustments to ensure that all patients, regardless of their individual needs have the same positive outcomes. As stated under the Equality Act 2010:- There is a legal duty to ensure that reasonable adjustments are made to deliver equality of access to healthcare services for disabled people. I hope this Special Edition of the NewsFair will continue to raise healthcare providers awareness within the health care setting and provide accessible information to people with sensory loss. Sharon Matthews Equality and Diversity Champion University Dental Hospital 3

4 All Wales Standards for Accessible Communication and Information for People with Sensory Loss Definition The term people with sensory loss is used throughout the article to refer to the following: People who are Deaf; deafened or hard of hearing; People who are Blind or partially sighted; People who are Deafblind: those whose combined sight and hearing impairment cause difficulties with communication, access to information and mobility. Purpose The purpose of these standards is to ensure that the communication and information needs of people with a sensory loss are met when accessing our healthcare services. There are a number of standards that reflect best practice in the delivery of accessible information and communication for people with sensory loss. The Health Board is committed to achieving these standards. These standards apply to adults, young people and children. Legal Duty There is a legal duty under the Equality Act 2010 to ensure that reasonable adjustments are made to deliver equality of access to healthcare services for disabled people. This duty is anticipatory and requires us as a public body to be proactive in making adjustments to ensure all access and communication needs are met. The UN Convention on the Rights of Persons with Disabilities provides an international standard for disabled people s human rights. Effective and appropriate communication is fundamental to ensuring services are delivered in ways that promote dignity and respect. The evidence also demonstrates that ineffective communication is a patient safety issue and can result in poorer health outcomes. So how should we be assessing and meeting information and communication needs? Here are just a few examples: All frequently used information leaflets and documents intended for patients and the public should be available in accessible formats for people with sensory loss. In accordance with the specific duty all public and patient areas should be assessed to identify the needs of people with sensory loss. This should include in particular outpatient areas, primary care and community services. The assessment 4

5 must involve people with sensory loss and ensure that their views are reflected in any proposals to design, develop or change a service. Effective engagement is critical to developing relationships of trust and understanding the experiences of people with sensory loss as recipients of healthcare. All staff who have daily contact with patients and service users, including receptionists, nurses, doctors, therapists, healthcare support workers and other support staff should be trained in how to communicate effectively with someone with sensory loss. This training should reflect a person centred approach which encourages staff to use clear speech and respond appropriately to individual needs. This applies in particular to staff based on inpatient wards with significant numbers of older patients. Where appropriate, staff should be trained in the use of different communication systems, for example, the use of Text messaging, hearing induction loop systems and basic British Sign Language. All written communication, for example, appointment letters, should be provided in accessible formats for patients with sensory loss and in plain English to help those who do not have English as their first language, including BSL users and the Welsh language. In every instance the individual patient should be asked to indicate the appropriate format for them. A full copy of the Standards can be found on the Welsh Government website. 5

6 Margaret McLaughlin In our second series of articles talking to members of the University Health Board, Sharon Matthews and Jacqueline Hall pose the questions in an interview with Margaret Mclaughlin. We find out what is involved in being an Independent Member for the Health Board, why equality and diversity is important and what the vision is for the future. Margaret has extensive experience and knowledge from the third sector and maintains strong links with local third sector organisations to strengthen the links between them and the Health Board. After moving to Wales, I worked for County Voluntary Councils (third sector umbrella organisations) in Cardiff and Merthyr Tydfil for 15 years, four of those as Director of Voluntary Action Cardiff. More recently, I have undertaken development work for Pedal Power, a local third sector cycling organisation that brings cycling to all, including disabled children and adults. Before becoming an Independent Member at Cardiff and Vale UHB I had lots of connections with health organisations through many years partnership working to deliver local services in the community. 6 Can you tell us a bit about your background? I graduated with a degree in Spanish and a post graduate diploma in community and adult education from University of Edinburgh. My career path started in health and social care organisations in the third sector starting with the Scottish Association for Mental Health in Edinburgh. I then moved to London and worked for 10 years for Peter Bedford Housing Association. This was an innovative and person-centred organisation which resettled people into the community who had been institutionalised. These included homeless people, people with a learning disability and, following the closure of a large local psychiatric hospital, those with mental health problems. Can you explain your role as an Independent Member of the Board at Cardiff and Vale UHB? I am the Independent Member on the Board from the Third Sector and my role is to bring independence, an external perspective, my skills and to challenge strategy development. I also contribute to the overall governance of the Health Board by holding Executive Officers to account on all aspects of policy and planning and overseeing the implementation of the Board s strategic objectives. I am Chair of the Equality and Diversity and Human Rights Sub- Committee and a member of several Committees including Quality, Experience and Safety, Mental Health Legislation, Charitable Funds and Information Governance Sub Committee.

7 I am also a champion for Board s Carers Champion, Equality, Diversity and Human Rights Champion and Welsh Language Champion and the Independent Member lead for the Health Board s Third Sector Strategic Framework. In practice, the role involves a lot of reading, researching, asking questions and offering advice where appropriate. It also involves regular patient safety visits to frontline service areas to meet staff, learn about safety and encourage and support improvements. and human rights the attention they need and deserve. The challenge is to demonstrate that consideration of equality and Welsh language issues from the outset helps with planning and providing the services that people need. It also helps to send the message to staff members of all backgrounds that they are welcome and valued. Continued... For me as the Independent Member from the third sector, it also means maintaining strong links with local third sector organisations and strengthening links between them and the Health Board. What challenges have you encountered in your current role? Cardiff and Vale UHB faces many challenges, for example, a growing population, an ageing population with increasingly complex needs, being a dispersal area for refugees and asylum seekers, having a large prison with high prisoner turnover and owning lots of estate that is in need of repair. On top of this, it has 60 high level priority performance measures which it works hard to be compliant with; and needs to find financial savings year on year. Against this background it can be hard to convince already busy Clinical Boards to give equality, diversity 7

8 Sensory Loss is the current equality theme. What immediate plans does the UHB have to implement a strategy to support necessary change /improvements for people with sensory loss? The Health Board is working to comply with the All Wales Standards for Accessible Communication and Information for People with a Sensory Loss. This was launched in December 2013 by Welsh Government and put together by service users under the auspices of Royal National Institute for the Blind (RNIB) and Action on Hearing Loss (AHL). Service users reported a frequent failure by the NHS to communicate with them effectively and even take into account their hearing or visual needs. A Health Board wide workshop was held in December 2014 and identified three areas for the organisation to focus on over the next year: communication, awareness raising and staff training. There will be an update to the Equality, Diversity and Human Rights Sub Committee (EDHRSC) on how we are doing against these themes in June In addition, individual Clinical Boards are being asked to identify how they will progress the Sensory Loss Standards and report on their achievements as part of their selfassessment against the Health Board s own annual Healthcare Standards. Since the results from last year were not that good, a workshop is planned for Clinical Boards to help them achieve this. So, all Clinical Boards are urged to attend if they wish to learn more about how to better address the communication needs of patients with sensory loss. What has been your or UHBs greatest / best achievement? To maintain a consistent focus on areas that are not obviously linked to the achievement of Tier 1 targets but which are nevertheless strongly linked to shaping the kind of culture the Health Board wishes to achieve. This includes equality issues and Welsh language, patient and carer involvement, stakeholder involvement including third sector organisations. By consistently offering constructive scrutiny on these areas, they are less likely to be missed. I am pleased that the EDHRSC has helped to make Equality Impact Assessments an integral part of our IMTP (Integrated Medium Term Plan) process and are the first Health Board in Wales to do so but it is far from perfect still! What is your vision for equality in the UHB? I would like it to be a place where advancing equality and the Welsh language becomes second nature 8

9 Wouldn t it be great to walk into the Health Board and know straightaway from what you see and hear that it is passionate about advancing equality? and unselfconscious. Wouldn t it be great to walk into the Health Board and know straightaway from what you see and hear that it is passionate about advancing equality? For staff, this means a workplace where individuals from all backgrounds feel valued, welcomed and are offered opportunities for growth and development. It also means they have the confidence to support patients from protected characteristic groups. For patients, this means a caring organisation where patients needs are viewed and assessed holistically (including those linked to protected characteristics) and where barriers to access and engagement are understood. For example, the Dental Clinical Board in relation to patient information for people with learning disabilities have asked, What is the barrier to this group fully accessing our services? and have then gone on to overcome it. What message would you like to give to UHB staff? I am proud to be part of a Health Board that has so many dedicated, caring and hard-working employees. I am proud to be part of a Health Board which, thanks to our staffrun Rainbow Fflag Network was considered in 2014 to be one of the top 10 gay and lesbian friendly employers in Wales! I am proud to be part of a Health Board where individuals and individual departments take steps every day to address the equality and human rights aspects of individuals and communities care. Let s continue to roll out the good practice so that it becomes consistent and standardised across all of our services, so that others can learn from it, so it simply becomes part of how we do things around here. Margaret McLaughlin Independent Member, Cardiff and Vale Health Board (Third Sector) Did you know that there are Equality Champions throughout the Health Board? To find out more contact: Keithley Wilkinson, Equality Manager, Keithley.Wilkinson@wales.nhs.uk 9

10 A Positive Story for a Cardiff Client Accessing Hearing Assessment. Emily s Story Emily is a 52 year old lady with Down s Syndrome living in supported accommodation in Cardiff. Emily has lived at the same address for the past 7 years and staff had no concerns regarding her hearing levels. Emily would respond inconsistently to requests, sometimes ignoring staff but was described as hearing when she wants to. Her fluctuating responses were perceived to be part and parcel of her learning disability. Following an awareness raising session for staff provided by the Speech and Language Therapy team, Emily s support team manager recognised that some of Emily s behaviours may in fact be an indication of sensory loss. It was identified that she had not had her hearing or vision assessed for some considerable time. As part of an ongoing improvement programme, details of Emily s referral to Audiology were passed on to the Speech and Language Therapy team who provided accessible information to support the assessment process was sent to Emily. Staff were anxious that Emily would struggle to cooperate during the assessment and a reliable assessment would be unachievable. However, on the day, Emily demonstrated that she recognised the environment and staff from the visual resources she had been supported to look at (and had taken with her) and she managed a full assessment including wax removal from both ears. Emily s hearing assessment showed that she had a moderate/severe mixed hearing loss in her right ear and a severe high frequency sensor neural loss in her left. A mould was taken for a right digital hearing aid. Since her assessment Emily s support staff team have met to discuss the outcome of her hearing test and the implications for Emily in her everyday life. Small adjustments to staff practice in communicating with Emily have had significant results. For example, staff are now conscious they need to face Emily when speaking to her and to noise. Emily has also had a successful assessment of her vision and has been prescribed glasses. Emily demonstrated that she recognised the environment and staff from the visual resources she had been supported to look at (and had taken with her) and she managed a full assessment including wax removal from both ears. 10

11 A Thank You from Laura, a Blind Patient of the University Hospital of Wales Laura has visited the University Hospital of Wales several times in recent months both as an outpatient and inpatient, for an operation: Across the board, staff were helpful. When I was staying in hospital they made sure I knew where the bathroom was and where the buzzer was, so if I needed to go to the toilet I could make my own way there, but someone would also come to see if I needed help. They d check in on me every now and again to make sure I was ok and if I needed a drink or anything because, unlike other people, I can t just go to and fro when I need something. In the clinic, nurses would come and tell me if they were running late, and where I was in the queue and keep me informed about things as they progressed. Generally they d come and give me information, rather than me having to ask. If we had to wait a long time, one of the nurses would take me down to let my guide dog out on the grass, or give him water as well. If I was having a scan and the dog had to wait outside, then someone would look after the dog. All the staff were very good about guiding me when I needed it, and offering assistance rather than me having to ask. I wanted to say thank you to all the staff, but it didn t seem like there was any way to record thanks! The above is related to neurology B4 ward, but Laura emphasised that during her inpatient stay she had various x-rays and scans, and that the staff in these other departments were also really helpful too. In the clinic, nurses would come and tell me if they were running late, and where I was in the queue and keep me informed about things as they progressed. Generally they d come and give me information, rather than me having to ask. 11

12 Introducing Grace Garnett - Enhancing Communication for People Who Have Hearing Loss On Wednesday 4th March 2015 Grace Garnett a lipreading coordinator and tutor with Wales Council for Deaf People delivered a two hour taster session. Staff learned about enhancing communication tactics with people who have hearing loss - such as first getting the person s attention and facing them, reducing background noise if possible, speaking normally but at a slightly slower pace not exaggerating or shouting, if giving specific information being prepared to ask the person to repeat it back or write it down, and being ready to rephrase a sentence if the person is having difficulty lipreading. Grace gave staff the title of a short story and related the story without voice so staff could practice lipreading themselves. By knowing the topic of the story/conversation one can anticipate what might arise. This was followed by a group exercise where each had to say a sentence without voice and their colleagues had to lipread what was said. Everyone enjoyed discovering that some words, although having a completely different meaning, had a similar lip pattern, e.g. toilet / chocolate, married / buried, ginger jar / cha cha cha just say these words in front of a mirror without voice and you will see what we mean. Can you imagine what it would be like to no longer hear the familiar voices of loved ones or even the purr of a contented pet? Or no longer hear the sound of approaching traffic? 12

13 Often when a person loses their hearing, they lose confidence as well. They may not put themselves forward for promotion even though they have the expertise because of the fear of missing vital information in group situations and meetings. Even worse, mishearing and giving an inappropriate response. A person may ask others to go shopping for them because they are afraid they will not hear what the cashier might be saying. They may withdraw from social gatherings and events and this could possibly lead to isolation and lonliness as well as other emotional or mental health problems. Wales Council For Deaf People is celebrating its 60th anniversary in 2016 and is the only truly Welsh National Deaf Organisation with nearly 60 years experience of supporting Deaf and Hard of Hearing people in Wales. The charity also provides support to community groups throughout Wales, runs a freelance communication agency and is a provider of training, including sensory loss, to groups and organisations. Please feel free to contact us at any time during usual office hours:- Wales Council For Deaf People Reg. Charity No: Glenview House, Courthouse Street, Pontypridd CF37 1JY (voice) (text) (fax) mail@wcdeaf.org.uk 13

14 Learning to Lipread... What is Lipreading? Lipreading, is a way of understanding speech by visually interpreting the movements of the lips i.e. watching the lip shapes, facial expression, natural gesture, together with any residual hearing. Just about everyone lipreads to some extent without even realising it, even people with perfect hearing, especially in noisy surroundings. However, to become a really good lipreader requires skill, technique and concentration. If you realise you are losing your hearing it is useful to start learning how to lipread now before it worsens. Some words look the same - they have the same lip pattern but are completely different in meaning. For example: summer/ supper and buy/ my/pie. A lipreading teacher will show you how to tell the difference. Can Lipreading help me? Yes most hearing loss experts recommend that people of all ages with any degree of hearing loss learn to lipread. It is better to learn with other people, perhaps in a group or in a class. Although you can t learn to lipread everything, we will give you the tools and awareness to develop your skills. The sessions help improve confidence and self-esteem in a safe environment. You do not have to be hard of hearing to attend, you may just want to accompany a partner or friend. Where Can I learn to Lipread? To find a local group you can contact Wales Council for Deaf People (contact details on this brochure) or visit org.uk (or type Association of Teachers of Lipreading to Adults in one of the search engines on your computer). If there isn t one in your area, ask your local adult education centre or college to provide one. If there is enough demand they may consider it. What are Lipreading skills sessions like? Lipreading sessions are very informal and friendly and are taught by a qualified tutor of lipreading. It is not like school; you can go at your own pace and the tutor will encourage you to have a laugh and relax. Your tutor will demonstrate the different shapes that sounds make on the lips so that you can identify them. They will show you how to take note of the position of the tongue when certain sounds/letters 14

15 What should I remember when lipreading? Here are some useful tips: Find a quiet spot Say that you lipread before you start the conversation Ask the speaker to face the light Sit or stand on the same level as the speaker Clarify the subject of the conversation first During the conversation Stop the speaker as soon as you miss something, or you may not be able to catch up later Ask people to repeat what they have said or to say it in a different way Remember to keep a pen and paper handy are formed. They will also explain how to fill in the gaps of speech that you can t hear, and how to use clues from the context of the conversation and body language. Attending lipreading sessions is an ideal way to meet other people in a similar situation to you and share experiences with people who have different degrees of hearing loss. Contacts: WCDP Lipreading Co-ordinators Grace Garnett or Wayne Davies Tel: (01443) or Gracelr@wcdeaf.org.uk or Waynelr@wcdeaf.org.uk WCDP main address: mail@wcdeaf.org.uk You ll pick up lots of tips and practical information to help you cope with your hearing loss! 15

16 A Patient Case Study I saw a lady patient on the C7 ward in UHW. The lady had one hearing aid but was having trouble using it. I spent some time showing her how to use it and also did a routine check on the hearing aid to make sure all the parts were working, I also gave her some tips and pointers on fitting it herself. I used the SONIDO listener to communicate with this lady while doing this and when she tried it on she was blown away by it. She said how it made her human again and that it made such a change as she was now able to hear clearly. Recommendations were given to staff on the ward to support this patient with her hearing aid use during her hospital stay. This in turn opened up the need for training for said staff as they did not feel they knew enough about hearing aid handling. I liaised with the Audiology Department training for C7 ward was arranged for the 23rd December In the meantime the lady (now discharged) has been loaned a SONIDO listener by Action on Hearing Loss for her to use over the Christmas period, she said that it was the best Christmas present I could have ever wanted and she is planning on getting one for herself in the new year. She was able to partake in conversations with her family and did not feel that she was isolating herself from social situations. I have also been in contact with Audiology regarding them doing some hearing aid refresher sessions at this lady s home. Chris Lazo Sensory Loss Service Manager Integrated Discharge Service C1 Link Corridor UHW Cardiff CF14 4XW 16 I gave her some tips and pointers on fitting it herself. I used the SONIDO listener to communicate with this lady while doing this and when she tried it on she was blown away by it. She said how it made her human again and that it made such a change as she was now able to hear clearly.

17 News Release The Cardiff and Vale University Health Board have set their first ever equality theme as Sensory Loss. With that in mind I sought information on the internet and found two videos that involve LGBT people who are also deaf. Please use the links below to watch them: edajjvua&feature=youtu.be watch?v=gqszluzgjhm We also got in touch with a Cardiff based deaf LGBT group, but unfortunately this is no longer in existence. If, however, anyone would like details of other organisations for deaf LGBT people I can get these sent out. As a network we are aware that our members may have multiple identities that go with their LGBT identity and we are hoping to share other information regarding these in the near future. Please note that these videos are not viewable within the health board but if you send them home you should be able to watch them there. Kind regards Helen and Reg Co-Chairs Rainbow LGBT FFlag Network Interested in learning Welsh? The organisation is currently offering ten free places for each clinical board on a Welsh language course. It will be an opportunity for staff to learn Welsh from scratch or to improve their existing Welsh language skills. The Cardiff University Welsh Language for Adults Centre will run the courses. Please talk with your line manager to put in your application for a free place. If you want to find other ways to learn or develop Welsh skills, then please visit the Welsh learning section on the intranet website: (A-Z - > Welsh Language - > Want to Develop Welsh Language Skills?) There is a whole range of means you can learn, either through e learning or in local classes and activities. For more information, please contact the Welsh Language Officer Alun Williams: ext or Alun.Williams4@wales.nhs.uk Croesewir gohebiaeth yn y Gymraeg neu yn Saesneg. Correspondence is welcomed in Welsh or English. 17

18 Wales Vision Strategy Conference Keithley Wilkinson I recently attended the Wales Vision Strategy Conference to find out how everyone at the UHB could make a difference to people with sight loss. The conference this year was free to organisations like ours. There were constructive conversations with policy influencers and experts from across Wales discussing the important legislative developments in how equality relates to planning and transport. As well as attending a workshop with colleagues from across Wales, we also heard first hand from people with sight loss. Most of us will moan about parking but almost three quarters of UK adults (74%) have been forced to walk into the road because of a vehicle parked on a pavement, according to a survey commissioned by Guide Dogs. The charity believes they are a danger to other pedestrians such as elderly people, wheelchair users and those pushing buggies who are then forced onto the roads. The charity is leading a campaign to call for a new law to ban parking on pavements and is asking politicians to back a private members bill which will be tabled on 12 September. Guide Dogs is concerned that cars, vans and other vehicles parked on pavements are making town centres and cities into no go areas for people who are living with sight loss. We also found out more about the cutting edge developments and emerging technologies that will help to make our environments inclusive. There was an expert panel in the afternoon chaired by Ruth Hussey, the Chief Medical Officer for Wales. 18

19 Upon leaving the conference I left with a better understanding of what it is like to navigate the world if you have sight loss and what needs to be done ensure people (patients) are not cut off from the world. Did you know that: Every day in Wales three people start losing their sight and that over fifty per cent of all sight loss is avoidable. It is predicted that by 2050 the number of people with sight loss in the UK will double to nearly four million of us. Nearly half of blind and partially sighted people feel moderately or completely cut off from people and things around them. Many long term conditions, such as diabetes and dementia, pose a significant risk to eye health. The projected increase in the elderly population and the number of people with multiple long term conditions has a knock on effect on long term planning for our services in terms of how we demonstrate care for our patients. I think Laura s Story is an example of how good we can be. If not tackled properly, poor provision at a primary care level is likely to increase pressures elsewhere in the health and social care system. What you can do? Increase your awareness of health conditions and disabilities where sight loss is a known link in the work that you do. Work with your colleagues and to educate children, families and carers about the importance of sight tests. Increase awareness of eye health amongst colleagues and particularly primary and community care professionals. Invite organisations such as the RNIB or Sight Cymru Wales to attend team meetings to raise awareness of sensory loss issues. Should you want more information please contact Keithley Wilkinson on or (internal) or by internal . 19

20 Extract from Improving Access for British Sign Language Users - Checklist for Health Boards and NHS Trusts Acknowledgements The British Deaf Association (BDA) would like to thank the following people and organisations for contributing to this document and for their feedback. First, we would like to thank the Deaf community in South Wales for sharing their experiences, providing feedback and giving their suggestions as to how we can improve and change current systems. This document could not have been produced without them. We would also like to thank the local Sign Language Interpreters for their input. Finally, thanks are due to the following organisations which contributed to the development of the Checklists. Welsh Ambulance Services NHS Trust Hywel Dda Health Board Cwm Taf University Health Board Abertawe Bro Morgannwg University Health Board Cardiff and Vale University Health Board NHS Wales Centre for Equality and Human Rights Introduction The BDA is asking Health Boards and NHS Trusts in Wales to use these checklists for improving access for British Sign Language (BSL) users. This is in accordance with the All Wales Standards for Accessible Communication and Information for People with Sensory Loss known as the All Wales Standards. The All Wales Standards clearly state that there is: A legal duty under the Equality Act 2010 to ensure that reasonable adjustments are made to deliver equality of access to healthcare services for disabled people. This duty is anticipatory and requires 20

21 public bodies to be proactive in making adjustments to ensure all access and communication needs are met. The UN Convention on the Rights of Persons with Disabilities (UNCRPD) provides an international standard for disabled people s human rights. Effective and appropriate communication is fundamental to ensuring services are delivered in ways that promote dignity and respect. The evidence also demonstrates that ineffective communication is a patient safety issue and can result in poorer health outcomes. In addition to this, the UNCRPD states in Article 9 Accessibility, Section 2 (e) that States parties shall also take appropriate measures to provide forms of live assistance and intermediaries, including guides, readers and professional sign language interpreters, to facilitate accessibility to buildings and other facilities open to the public. The checklists in this guidance are designed to be complementary to the All Wales Standards and set out a number of key commitments with practical measures to improve access for Deaf people who use sign language. As stated in the All Wales Standards (section 4) there should be an assessment of healthcare settings accessed by patients prior to any action planning; and this should involve service users, including BSL users. These checklists have been produced in conjunction with Deaf BSL users, Sign Language Interpreters (who have a pivotal role in health interactions) and healthcare professionals. There are a number of ways in which people engage with the health system: People may need to attend a health setting, for example, a GP surgery, a community health clinic or a hospital out-patient clinic which often involves a period of waiting time. People may need to spend some time on a hospital ward for planned surgery or a medical procedure. People may need to have contact with ambulance and paramedic services and hospital accident and emergency departments. People engaging with the health system need to be able to communicate effectively with health professionals. People often need information after their diagnosis about how to take their medication or how to manage their health. Improving Access for British Sign Language Users - Checklist for Health Boards and NHS Trusts 21

22 Each commitment requires action to overcome the disadvantages that Deaf people using BSL face when accessing health services. The benefits that will ensue from delivering the commitments are also listed. The five commitments are: 1. Ensure access for Deaf people to information and services at first points of contact. 2. Promote equal access in health settings, particularly in reception areas. 3. Ensure accurate diagnosis and appropriate treatment. 4. Provide clear and accessible information about treatment and management of health. 5. Engage and involve local Deaf communities on a regular basis. Commitment 1 Ensure access for Deaf people to information and services at first points of contact. Rationale Deaf people face many barriers when trying to access information or services, either through lack of awareness or language barriers. Many Deaf people are often unable to access written information. Comments by Deaf people My surgery s great, I can book by text or online. I have to physically drive to my GP surgery to take a note to book an appointment. I was in A and E; the receptionist didn t know how to book an interpreter. I had a follow-up appointment but the letter didn t say if an interpreter had been booked. What I don t understand is how some departments are great, they know just what to do, others - especially A and E haven t got a clue! My dentist is really Deaf aware; the surgery texts me when I need a 6 month check-up. Staff still don t know they should book a qualified interpreter or how to do it. The objective The health provider recognises and values all its patients, including those who use BSL by ensuring that there are no barriers to booking appointments, receiving notifications and ensuring that there are opportunities to have Sign Language Interpreters when required. This ensures that Deaf patients have the same quality of engagement, information, and right to be consulted as everyone else. 22

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24 Equality & Diversity Bwrdd Iechyd Prifysgol Caerdydd a r Fro Cardiff and Vale University Health Board Designed by Dental Illustration Unit