See Hear: Are deaf people being let down in hospitals?
Deaf people have been going on record about difficult experiences they've had in hospitals due to lack of sign language interpreters. See Hear looks at three cases where this trauma could have been avoided had sign language interpreters, or other communication support, been provided.
Deaf couple Nadia and Hulusi Bati were in University College London Hospital for the birth of their child. It was all going fine until the sign language interpreter's shift ended at 20:00 while Nadia was having contractions and 90 minutes before she went into the final stages of labour.
Despite efforts from the staff, no interpreter was present at the birth which turned out to be a difficult forceps delivery. Nadia only held her baby for a moment before it was whisked away for emergency treatment in another room - they were unable to tell her why.
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The child was treated in hospital for several days afterwards though the parents didn't know what was wrong because sign language support was not forthcoming here either.
Dr Pat O'Brian, Clinical Director, Women's Health, says the hospital does not comment on individual patient matters but told See Hear they had provided interpreters on-site for 97% of cases. He says: "It's probably fair to say that of those 3% that we found it difficult to provide a face-to-face interpreter, it is more common in emergency situations."
If you have a potential life-threatening condition, the priority for medical staff is to assess you and treat you appropriately. Finding an interpreter isn't always possible at short notice, as Matthew Gurney found when he was rushed to hospital with suspected appendicitis in the early hours of the morning.
On arrival he provided the number of an interpreter he knew. She wasn't available; its unclear what further steps were taken by North Middlesex University Hospital to find another. Instead Gurney and a deaf friend communicated with hospital staff through pen and paper but important details weren't communicated effectively. It's understood widely in the deaf community that detail can easily go astray in all types of conversations.
Gurney signed a consent form for an operation. On waking briefly after the anaesthetic he saw three marks on his stomach which he had understood from the staff meant that he had only had exploratory surgery; he was relieved. ON waking fully later, he learnt that he'd misunderstood and that his appendix had been taken out after all.
He left hospital having had no interpreter support for the duration of the stay.
A spokesperson for the hospital says they attempted to find an interpreter but none were available. Gurney left the next day and the hospital were satisfied he knew how to look after the wound after having been given advice though agree it would have been good to have an interpreter at that discharge meeting.
The Equality Act of 2010 exists to protect people against unfair treatment on the grounds of deafness or disability but, under law, communicating via pen and paper could be considered a "reasonable adjustment".
A recent report from Signhealth, a deaf charity focusing on the health and wellbeing of deaf people, finds that deaf people are falling behind their hearing counterparts in terms of general health. They're reluctant to go to their local doctor or hospital, expecting communication to be difficult or impossible.
But why is basic communication sometimes failing to materialise?
Dr Andrew Alexander, one of the key people behind SignHealth's report, thinks it may be a question of perception: "Hospital staff tend to think the interpreter is for the deaf person. They fail to recognise that the interpreter is also for the hearing member of staff. It's vital in a doctor-patient relationship to have good communication."
Philip Dixon had "good communication" for an appointment at York Hospital to discuss the results of a scan though, in his case, it was provided by his hearing son Matt who can speak BSL. On discovering an interpreter had not been booked, the two had decided they'd go ahead with the appointment to avoid further delay.
Interpreting the doctor's words, Matt was shocked that it had been left to him to tell his own father that he had terminal cancer. Not being trained in medical language as an interpreter would have been, the difficulty was further compounded by the fact that Matt didn't know the signs for some of the medical terminology and had to muddle through.
It happened several years ago, and his father died soon after, but Matt says he relives the experience daily. Looking back he wishes they had pushed for an interpreter and says: "Being put in that situation for me meant, instead of me supporting him, he had to support me because I was so upset. And that's wrong. If an interpreter had been there I could have sat next to my father and supported him through it and focus on consoling him."
A spokesperson for York Hospital says they were sorry to hear of Matt's experiences and says their protocol is to provide interpreters to patients who need them and they've been monitoring and improving interpretation services in the last year.
When deaf people feel they aren't getting the right level of service, they can raise the issue via the Patient Advice and Liaison Service (PALS), their GP, or elsewhere. Change should happen as a result - and if it doesn't, then The Equality Act gives deaf patients the right to take that complaint further.
On this week's programme, See Hear raises these stories with Neil Churchill, the Director for Patient Experience for NHS England. He says: "where the NHS has got something wrong and that's given somebody a poor experience of care, then we need to apologise and we need to learn from that. I think everybody is interested in making sure that if something has gone wrong, it doesn't happen again.
"My goal really is to put patients in positions of real influence where they can assess the quality of care and identify what improvements Trusts need to make in order to routinely deliver consistently great experiences of care."