Diversity and equal opportunities - Effective communications

This Resource Guide provides information on effective communications with diverse populations of service users, patients and their supporters, carers and families.

The Human Rights Act 1998 and other legislative changes such as the Disability Discrimination Act 1995 (as amended) provide a strong case for the provision of effective communications in hospitals, in the community and in GP practices. Wherever possible, communications should be provided in languages and formats appropriate to the patient group, including people with sensory impairment, for example:

A service provider who offers services to the general public has a legal duty:

• to provide a BSL/English [Irish] interpreter if it would enable or make it easier for Deaf people to make use of its services, or
• to change a practice, policy or procedure which makes it impossible or unreasonably difficult for Deaf people to make use of its services (with or without a BSL/English [Irish] interpreter).

The service provider has an anticipatory duty, which means that the service provider has to think in advance about when a BSL/English [Irish] interpreter may be required, and make the arrangements necessary to ensure that a BSL/English [Irish] interpreter is effectively used¹.

Practical tips and information

• Try to look at your patient/service user and not at the interpreter when you are speaking, even if the patient/service user cannot understand you. This can reduce certain anxieties or suspicions from your patient/service user.
• If the patient/service user is lip reading face them, speak distinctly and do not sit in shadow or in front of a bright light or window.
• Remember that the interpretation process takes time, and ensure that background noise is at a minimum.
• Some people who most need information in their own language may not be literate in any language.
• When speaking to a person who has a hearing impairment, an expressive and mobile facial expression gives more clues than a passive one. Eye contact is very important. Don’t be put off if you are watched very carefully. The way you speak can take some getting used to.
• Be aware that non-medical staff - for example, receptionists, ancillary staff, security personnel, porters - are usually the first people that service users and patients encounter. Communication problems with a busy receptionist or failing to get the attention of a porter can cause distress or discomfort for a range of patients/service users who have specific communication requirements.
• Patient information (leaflets, posters etc) and important signage and announcements should be in plain language and accessible to all the main groups served by the healthcare organisation (for example, Braille, audiotape, community languages where appropriate).
• Written communications should be in large print (at least 16 point, preferably 18 or 20).
• It is much easier to understand information that is broken down into short paragraphs with bold headings and not too tightly packed on the page. Illustrations, diagrams and pictures can make material more interesting and more accessible.
• To further illustrate the need for effective communications, the information presented at
  http://www.equalityhumanrights.com/en/Pages/default.aspx (the Equality and Human Rights Commission), explains the rights of disabled people under the law, including the fact that the success of medical treatment may depend upon an individual having additional support such as ‘information about taking medication in an easy-to-understand language or large type’.
• In terms of good practice, there are many groups who need support services to reduce access inequalities.

The following web links provide examples of good practice across a number of healthcare institutions.

Key Web Links

Clinical communication

www.intellectualdisability.info
This web-based learning resource for medical and healthcare practitioners includes: How to… guides: Top Ten Tips for clinical consultation,
Clinical Communication and Communicating with Pictures.

Blind and partially sighted people

The Royal National Institute for the Blind’s website includes guidance on Information regarding adjustments most relevant to blind and partially sighted people, for example, lighting, signage and colour contrast.

Deaf and hard of hearing people

The Royal National Institute for the Deaf site provides Communication Factsheets, such as Communications Tips. The range of leaflets includes

• The duty to provide a sign language interpreter under the Disability Discrimination Act and
• The information needs of black and minority ethnic deaf people.

Emergency Multilingual Phrasebook

The Department of Health website's publication section includes various languages including Amharric, Bosnian-Bosanski, Farsi, Kurdish, Slovak, Welsh. (Downloadable PDF files.)

General information

The National Disability Information Service UPDATE Scottish Formats provides contact details of transcription, translation, interpretation and other communication services. Mainly Scottish organisations, but service providers in other countries are also listed. (Scotland)

Communication and interpreting services

The Central Liverpool Primary Care Trust website contains a Communications for All: handy hints manual which is a practical booklet on effective communications with all types of patients and service users.

Ulster Communities and Hospitals Trust: See Policy on Access to Interpreting Services for People from an Ethnic Minority Background which is available on the Ulster Community Hospitals Trust’s site (Northern Ireland)

United Hospitals Trust (Northern Ireland): See Interpretation, Translation and Dietary Requirements Relating to People from Ethnic Minorities.

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Footnotes

1. The duty to provide a British Sign Language/ English (/Irish) interpreter under the Disability Discrimination Act 1995: A QUICK REFERENCE GUIDE for employers, trade organisations and service providers (DRC, RNID, BDA, n.d.), p9. return to paragraph containing footnote 1)