Interpreting & Translation Policy and Procedure

Interpreting & Translation Policy and Procedure Controlled document This document is uncontrolled when downloaded or printed. Reference number Version 2 Author Name & Job Title Executive Lead WHHT: G026 Ian Stevens Head of Litigation & Claims, SIs, Complaints and PALS Tracey Carter, Chief Nurse Consultation Policy & Guideline Review Group/ July 2017 Ratified by Date ratified 19 th July 2017 Committee/individual responsible Issue date July 2017 Review date July 2020 Target audience Additional Search Terms (Key Words) Previous Policy Name Quality and Safety Group (Chairs action) Quality and Safety Group All WHHT Staff Interpretation, translation, interpreter, foreign language, first language' N/A

CONTRIBUTION LIST Key individuals involved in developing this version of the document Name Ian Stevens (IJS) Designation Head of Litigation & Claims, SIs, Complaints and PALS Ratified by Group/Committee Quality & Safety Group- July 2017 (Chairs Action) Change History Version Date Author Reason for change 1 March Paul Gibbs, Patient New Policy 2012 and Public Involvement Manager 1 22 August Lesley Lopez Formal review-extension agreed 2016 2 July 2017 Ian Stevens, Head of Litigations, Claims, PALS and Complaints (until December 2016) Formal Review and re-write Page 2 of 19

CONTENTS 1 Aim... 4 2 Objectives... 4 3 Definitions... 4 4 Scope... 4 5 Responsibilities... 4 6 Procedure... 5 6.1 Interpreting... 5 6.2 Translating... 8 7 Evaluation measures... 10 7.1 Monitoring- please see the table below... 10 7.2 Audit & Review- please see the table below... 10 Monitoring & Compliance... 10 8 Review... 11 9 Safeguarding... 11 10 Service User Involvement... 11 11 Equality Impact Assessment Statement... 11 12 References...Error! Bookmark not defined. 13 Related Policies... 11 14 Equality Impact Assessment... 12 15 Policy and Procedure Sign-off Sheet... 13 Appendix 1 Interpreting and Communication Support... 16 Appendix 2 Using an interpreter... 18 Appendix 3 Guidelines for clinical staff on the use of an interpreter... 19 Page 3 of 19

1 Aim The aim of this policy is to provide information and guidance in ensuring that there are measures in place to support communication with non-english speakers, people with whom English is not their first language, sign language users, people with hearing or visual impairment, people with learning disabilities and people who require Deaf or Deaf Blind communications. 2 Objectives To provide an accessible and cost effective interpreter and translation access for patients who require these services To improve the experience of patients who require these services. To inform how interpretation and translation services can be accessed. 3 Definitions Many people use the terms translation and interpreting interchangeably, so it is important for the purposes of this Policy to denote the difference between the two; Interpreting deals with the spoken word; Translation deals with the written word. 4 Scope This policy applies to all areas and all staff within this Trust who deal with people for whom English is not their first language. 5 Responsibilities 5.1 The responsibility for the overall effectiveness of this policy rests with the Chief Executive and the Trust Board. 5.2 Trust Board Committees have the legal responsibility for adopting policies and strategies and ensuring that they are carried out effectively. 5.3 The Quality and Safety Group has responsibility for assessing the effectiveness of this policy. 5.4 The Patient Experience Group has a responsibility for development, implementation, review and monitoring effectiveness of this policy. 5.5 Divisional Directors and Divisional Managers are responsible for: Ensuring staff are aware of and implement this policy Ensuring that staff are compliant with it Bringing any issues which may affect implementation to the attention of the Head of Litigation & Claims, SIs, Complaints and PALS. Page 4 of 19

5.6 Managers and Team leaders will be responsible for: Ensuring that the policy is followed and understood as appropriate to each staff member s role and function Implementing the policy effectively and taking any issues which may affect implementation to Heads of Service This information must be given to all new staff on induction. 5.7 It is the responsibility of the Head of Litigation & Claims, SIs, Complaints and PALS to ensure the operational effectiveness of the interpretation and translation service on offer. 5.8 All Staff will be responsible for: Recognising when interpreting or translation needs exist Assess which language is being spoken Assess and make provision for that need Liaise with the interpreting service to arrange for an interpreter or communicator Accurately record with the medical records the language or dialect used, also include any directive from the patient regarding their interpretation or translation wishes. 5.9 Non-compliance with this Trust Policy may result in disciplinary action. 6 Procedure For the purposes of procedure, this section is split into interpreting and translation. 6.1 Interpreting Methods of interpreting Face to Face language interpretation (F2F) British Sign Language Interpretation (BSL) Telephone Interpreting (TL) Capacity and Consent A patient who cannot communicate because of barriers in language does not mean they do not have capacity. An interpreter is needed to assist patients and clinicians to assess capacity before treatment can commence with the exception of life saving treatment being necessary to save the patient. Procedures for Accessing Interpreters Page 5 of 19

As soon as a member of staff becomes aware that a patient (due to attend an appointment, day-case, admission or other visit to the hospital) will need an interpreter, they should follow the procedure detailed in this policy. Staff wishing to access interpreting and translation services should complete the Interpreting and Translation Request Form (Appendix 1) and submit to the Patient Advice & Liaison Service (PALS) at Watford General Hospital, as follows: By email: pals@whht.nhs.uk. By fax: 01923 217245 Outside of the hours of 9AM and 4PM between Monday and Friday, the provider of interpreters (including BSL) and translators can be contacted directly. Each ward and the Emergency department will have been provided with the direct contact details by the PALS service. If you do not have the details please contact another ward outside of office hours or PALS during office hours. Use of Carers, Relatives or Friends to Provide Interpreting Services Carers, Relatives or Friends should not be asked or expected to interpret. The reasons for this are that a person using Trust services may wish to communicate confidential information and has a right for confidentiality to be respected. In addition carers, family or friends may not be able to communicate information on an impartial basis and there is strict legislation on the basic qualifications and training an interpreter must have to provide an interpreting service. It may be appropriate in an acute or emergency situation for a carer, friend or family member to communicate basic information (for example day to day activities or directions), however all services users must be offered interpreting services at the earliest opportunity. If a Service User refuses to use a professional interpreting service then this decision should be confirmed through a telephone interpreting service or face to face with and interpreter and recorded in the person s notes. An interpreter should still be offered with each encounter. Children, Young People and Vulnerable Adults If there are issues related to child protection or vulnerable adults then a professional interpreter must always be used even to communicate basic information. Children (under 16 years) must never be used to interpret. The need for a professional interpreter in these circumstances should be conveyed to the Service User via a telephone interpreting service, if a professional interpreter is not easily accessible. A child may communicate very basic information in an emergency however telephone and face to face interpreting should be arranged as a matter of urgency. Use of Trust Staff Page 6 of 19

Staff with language skills may be asked to communicate basic information to a Service User; however as a general rule staff should not be used to provide interpreting services in lieu of professional interpreting provision. There are circumstances where this general rule will not apply, for example where a member of staff has been specifically employed as part of their role to communicate in a different language (including BSL). Where a member of staff is employed by an externally approved interpreting agency (taking account of contractual obligations laid down by the trust in relation to staff who hold posts in addition to their substantive post with the Trust) any interpreting undertaken in these circumstances must be arranged and approved by the agency and all parties should be clear that the member of staff must undertake this work outside of their normal working hours and they will be accountable to the agency in respect to this activity. Record keeping The requirement for an interpreter should be clearly recorded and this information made clear in any referral process irrespective of whether the particular referral form requires this. The preferred language of the service user should also be recorded. The name of the interpreter used should also be recorded. Emergencies Where there is a need to communicate information to someone as in an emergency, telephone interpreting services may be used. Events and Consultation The need for and use of BSL and language interpreting should always be considered at an early stage when planning events aimed at the public, service users or carers to ensure that these events are accessible. Preparation materials i.e. handouts should be made available to interpreters in good time so that they can review these. Cancellations It is the responsibility of all staff to notify the PALS team as soon as they become aware that a booked interpreter is no longer required. Wasted bookings cost the NHS money and it is everyone s responsibility to ensure this does not happen. Responsibility of clinicians during a consultation with an interpreter booked Clinical staff should refer to Appendix 2 for guidance. Page 7 of 19

6.2 Translating When to translate material The provision of translated material should be considered in all cases where care and or support involve providing written information to the person in receipt of such support. Providing translated material to an individual or small group When considering providing written translations the person responsible for the care and support of the individual should consider with them carefully their ability to use translated material and consider the most effective way of ensuring that a person has the information and is able to access it and review it. Translated material could include: Written translation Braille or Large Print Spoken translation (ie. a CD recording) Visual format British Sign Language When using or procuring translations staff should consider how the information will be used and the ability of the person receiving the information to use this in the proposed format. Requesting translation of a document To request that a document is translated please contact the PALS service between the hours of 9AM and 4PM Monday to Friday with details of your request. By email: pals@whht.nhs.uk (emails sent out of hours will be dealt with during office hours By fax: 01923 217245 Translating a document will take a number of working days before it is ready. Mail outs and consultation The audience for a specific mail out or event should be considered carefully by planners. As a general rule the availability of translated materials should be brought to the attention of participants in a timely manner so that arrangements can be made to obtain a translated copy of the material if this is requested. Arrangements for all consultations must include consideration of the need to provide information in a range of formats to ensure that it is accessible to all potential participants. Page 8 of 19

Clear information should be sent out with consultations on how to access a version in an alternative format, this should include information provided on Trust web sites and other types of publicity materials (e.g. posters) Surveys and Reviews When planning and undertaking surveys internally or as required by external bodies the need to ensure that the survey is accessible to all potential participants must always be considered. Surveys which are being sent to individuals must include details of how to obtain a translated version of the survey and/or how to access support to complete the survey. Consideration should also be given to signed surveys (i.e. providing the survey in a visual format of BSL) Page 9 of 19

7 Evaluation measures 7.1 Monitoring- please see the table below 7.2 Audit & Review- please see the table below Monitoring & Compliance Element to be monitored Lead Tool Frequency Reporting arrangements Accessibility to interpreter Services Audit of patient information given on interpreter services Head of Litigation & Claims, SIs, Complaints and PALS Head of Litigation & Claims, SIs, Complaints& PALS Audit using records of bookings supplied by the commissioned provider. Review of Complaints and PALS contacts concerning interpreters and translators. Audit and review of interpreter evaluations (usually provided to the provider of interpreters. Annually Annually Board Audit and Risk Committee Management Committee Patient Experience Group Annual service review with the provider of interpreters, Page 10 of 19

8 Review The content of this policy will formally reviewed every three years, maximum, or when warranted by a change in national guidance or Trust practice. The Quality and Safety Group is responsible for ratification of this policy. 9 Safeguarding The Trust must ensure that the provider for interpreters has sufficient systems and safeguards in place to ensure that the interpreters they supply are trained on how to raise concerns around safeguarding with the provider and with Trust staff. The Trust will ensure that details of the Trust s safeguarding team and how to contact them are available for the provider of translators. 10 Service User Involvement This policy describes the process for using an interpreter within the Trust. The policy benefits service users as it aims to provide better access for users to the Healthcare services and information they receive through the Trust. 11 Equality Impact Assessment Statement Please refer to section 14. 12 Related Policies Safeguarding adults Policy ( WHHT: C200) Trust Disciplinary Policy (WHHT: HR044) Page 11 of 19

13 Equality Impact Assessment 1. Does the policy/guidance affect one group less or more favourably than another on the basis of: Race Ethnic origins (including gypsies and travellers) Nationality Gender Culture Religion or belief Sexual orientation including lesbian, gay and bisexual people Age Disability - learning disabilities, physical disability, sensory impairment and mental health problems Marriage & Civil partnership Pregnancy & maternity 2. Is there any evidence that some groups are affected differently? 3. If you have identified potential discrimination, are any exceptions valid, legal and/or justifiable? 4. Is the impact of the policy/guidance likely to be negative? 5. If so can the impact be avoided? 6. What alternatives are there to achieving the policy/guidance without the impact? 7. Can we reduce the impact by taking different action? Yes/No Comments If you have identified a potential discriminatory impact of this procedural document, please refer it to (Insert name and position) together with any suggestions as to the action required to avoid/reduce this impact.

For advice in respect of answering the above questions, please contact (Insert name and position). 14 Policy and Procedure Sign-off Sheet Policy Name and Number: <POLICY/PROCEDURE TEMPLATE - replace with policy name> <DIV>/<IMS>/<00> Version Number and Date: MONTH YYYY No: <1 - This should be whole numbers only> Service Location: PLEASE INSERT SERVICE LOCATION All staff members must sign to confirm they have read and understood this policy. Name Signature Name Signature Page 13 of 19

Policy Ratification Form Name of Document: <POLICY/PROCEDURE TEMPLATE - replace with policy name> Ratification Date: MONTH YYYY Name of Persons Job Title Date Divisional Support (Direct Line Manager / Matron / Consultant / Divisional Manager) Consultation Process (list of stakeholders consulted / staff groups presented to) Endorsement By Panel/Group Name of Committee Chair of Committee Date <Governance Committee Name> Document Checklist 1. Style & Format Is the title clear and unambiguous? Is the font in Arial? Is the format for the front sheet as per Appendix 1 of the policy framework Has the Trust Logo been added to the Front sheet of the policy? Is it clear whether the document is a guideline, policy, protocol or standard operating procedure? 2. Rationale Are reasons for development of the document stated? 3. Content Is there an introduction? Is the objective of the document clear? Does the policy describe how it will be implemented? Are the statements clear and unambiguous? Are definitions included? Are the responsibilities of individuals outlined? Yes / No

Document Checklist 4. Evidence Base Is the type of evidence to support the document identified explicitly? Are key references cited? Are supporting documents referenced? 5. Approval Does the document identify which committee/group will approve it? 6. Review Date Is the review date identified? Is the frequency of review identified? If so is it acceptable? 7. Process to Monitor Compliance and Effectiveness Are there measurable standards or Key Performance Indicators to support the monitoring of compliance with and effectiveness of the document? Is there a plan to review or audit compliance with the document? Yes / No Name of Person completing Ratification Form Job Title Date Ratification Group/Committee Chair Signature Date <Governance Committee Name> Page 15 of 19

Appendix 1 Name INTERPRETING & COMMUNICATION SUPPORT Department/Ward/Clinic Request Form REQUESTOR DETAILS Contact No(s) Tel: Ext/bleep Date of submission Language or Support required, eg Dialect or BSL Date Interpreter required PATIENT / APPT DETAILS Please indicate day of week Duration (if more than an hour required, please state why) Gender of interpreter required MON TUES WEDS THURS FRI Start time : End time : Male Female No Pref. On-site contact name PATIENT DETAILS PATIENT NAME Patient Address Telephone number Hospital No. DOB Overseas / Private? YES / NO (if YES, please advise Finance Dept) Meeting place (full details) Dept, Level, and Location Page 16 of 19

Purpose of Appt (ie new or follow up) Special Requests? PLEASE SEND COMPLETED FORM TO PALS BY EMAIL: pals@whht.nhs.uk Telephone: (01923) 217968 Agency Name: Contact Telephone No: Interpreter Name: Date request submitted: PALS USE ONLY PALS Advisor: Datix Ref Confirmation date: Notes: Page 17 of 19

Appendix 2 Using an interpreter Only trained interpreters should be used in the interests of accuracy, confidentiality and accountability; family members, friends or un-trained people should not be used. Simultaneous interpreting (whispered): i.e. at the same time. This saves time and gives immediacy and flow to the conversation. The interpreter is listening, changing the language, and speaking all at once. You can help a lot by not speaking too quickly and by making short pauses at the end of each thought. Ask the interpreter for a few minutes technical run-through before the interview, if you have never used this method before. It really does save time. Simultaneous interpreting is like close-order marching. You re in the front rank, and the interpreter is following, half a pace behind you, but doesn t know where you re going. If you suddenly change direction, the interpreter will be unable to keep pace with you. It s as simple as that Consecutive interpreting : the interpreter will take notes while you speak, and then relay the message, while you wait. Taking notes is a sign of competence. When your message contains a lot of hard facts, such as dates and times, names and places, there is less risk of forgetting something vital if it has been noted down on the way. As with simultaneous interpreting, finish the thought before you stop speaking, pause after a few sentences to allow the interpreter to render the speech into the other language. Telephone interpreting can be set up quickly, but may not be appropriate in many medical situations. The service is generally managed through a central helpline set up by the provider and then routed to a call centre. Hints and Tips a) Think about the positioning of the interpreters so that they have a clear view of your patient and can hear what is being said. b) The interpreter is trained to interpret everything that is said in the meeting. Please be aware of this and that they will advise the patient and their representatives of the same. c) Speak slowly, clearly and concisely at all times. Avoid using jargon and popular expressions, puns and jokes these are often not translatable. d) Signal to the interpreter when you are going to change topic, or they may not be able to keep pace with you. e) Be aware that the interpreter may not know all the medical or more complicated terminology you are using to in another language and try to keep use of that language to its simplest form. The interpreters do keep their own glossaries of complicated and new medical terminology and they may ask you, after the meeting, to repeat certain words for this purpose. f) Your interpreter may intervene at times, intervening is a good sign, and interpreters use the Impartial Model of interpreting, and will only ask you to stop if: they cannot hear you, or if you re speaking too fast; they do not understand something; they think there is a misunderstanding; there is a missed cultural inference that is likely to cause misunderstanding. Page 18 of 19

Appendix 3 Guidelines for clinical staff on the use of an interpreter For the clinician Arrange a pre-meeting or discussion with the interpreter to explain what you need to address in this meeting with the patient. This is particularly important when there are sensitive issues to be discussed, such as terminal illness, child protection etc. Please make sure the interpreter is not kept waiting, they are often our staff and need to return to their own patients quickly. Always allow for extra time with the patient when an interpreter is present. 1. Please speak directly to the patient. 2. Speak 1 or 2 sentences, and then pause to allow interpretation. Be aware that interpreters are translating the meaning, not single words. 3. Use simple language, explaining the meaning of medical terminology as you go. 4. Express directly what you mean, do not use inferences (e.g. back passage ) as cultural differences may not recognise their translation. 5. Discussion between yourself and the interpreter, in front of the patient, will always be interpreted for the patient. 6. Please never ask the interpreter to do anything other than interpret. They are not there to provide emotional support, or advise patients on your behalf. 7. Remember that you, as the health professional, are responsible for ensuring that all communication with the patient is understood. Make sure you continually assess the patient s full understanding. Page 19 of 19